Lisa Margaret Kolesar, DPT, ACT/L

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1988 Issued in ID

Practice address

7979 W Rifleman St Ste 100
Boise, ID 83704-9066

Phone

(208) 377-3850

Fax

(208) 658-1360

NPI assigned

Apr 26, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Clinic of Idaho PLLC

  • Psychiatry Physician
  • Boise, ID
  • NPI 1215622048
  NPD
• Advance Physical Therapy for Orthopaedic and Sports Injuries, LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1740483411
  NPD (past)
• Peak Physical Therapy P C

  • Physical Therapist
  • Boise, ID
  • NPI 1073551560
  NPD (past)
• Peregrine Physical Therapy LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1942128137
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1376500124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S PHILLIPPI ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053646",
            "telephone_number": "208-866-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7979 W RIFLEMAN ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049066",
            "telephone_number": "208-377-3850",
            "fax_number": "208-658-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESAR",
        "first_name": "LISA",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "DPT, ACT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "1988",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "TD492",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010142952",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805753950",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy C Kois, M.D.
• Tyler Kojima
• Polina Kokoulina, PA-C
• Jason E Kolb, PA-C
• Peter H Kolb, DPT
• Christopher L Koller, RPH
• Paul Kolodge
• Beau Alan Kolodzieczak, LPC
• Lindsay Kolpitcke
• Anuhya Kommalapati, MD

• All providers in Boise, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.