Individual provider Active NPI

Kyra K Hootman, DO

  • Internal Medicine Physician
  • Pueblo, CO
National Provider Identifier
1437108131
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38729 Issued in CO
Practice address
2001 Lake Ave
Pueblo, CO 81004-3535
Phone
(719) 564-0300
Fax
(719) 564-0303
NPI assigned
May 9, 2006
Last updated
Aug 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38729 CO Primary

Addresses

Primary practice location

2001 Lake Ave
Pueblo, CO 81004-3535

Mailing address

2001 Lake Ave
Pueblo, CO 81004-3535
Phone (719) 564-0300

Other identifiers 1

IdentifierTypeStateIssuer
62781847MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081105000855 CA Practitioner - Internal MedicinePractitioner - Hospitalist 9234163494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

45 E River Park PL W
Fresno, CA 93720-1565
Phone (559) 320-0530

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.04 of 100Reported as group
Quality
78.62
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
10293CAMDMental Health Counselor
38729COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners CurrentSince Mar 1, 2022 Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

15 E Audubon Dr
Fresno, CA 93720
Phone (559) 433-8000

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1437108131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LAKE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043535",
            "telephone_number": "719-564-0300",
            "fax_number": "719-564-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAKE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043535",
            "telephone_number": "719-564-0300",
            "fax_number": "719-564-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOTMAN",
        "first_name": "KYRA",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "38729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62781847",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.