NPIMap

Individual provider Active NPI

Michelle Marie Klismith, M.D.

  • Family Medicine Physician
  • Monument, CO
National Provider Identifier
1437231990
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0053709 Issued in CO
Practice address
15909 Jackson Creek Pkwy
Monument, CO 80132-8693
Phone
(719) 522-1133
Fax
(719) 481-1620
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0053709 CO Primary

Addresses

Primary practice location

15909 Jackson Creek Pkwy
Monument, CO 80132-8693

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other identifiers 1

IdentifierTypeStateIssuer
81177836MedicaidCO

Other names 1

  • Michelle Marie Olds Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140916001775 CO Practitioner - Family Practice 7911194774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Colorado Medical Group LLCGroup PAC ID 2769706431, 187 clinicians

Practice addresses (Care Compare)

Colorado Springs, CO 80903
Phone (719) 538-2900

15909 Jackson Creek Pkwy
Monument, CO 80132-8693
Phone (719) 522-1133

1625 Medical Ctr PT
Suite 290
Colorado Springs, CO 80907-8722
Phone (719) 635-5148

Hospital & facility affiliations

  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031
  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

Merit-based Incentive Payment System (MIPS)

Final score
88.69 of 100Reported as apm
Quality
80.87
Promoting interoperability
90
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Colorado Medical Group LLC CurrentSince Feb 1, 2020 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Feb 1, 2020 Accepting new patients
Optumcare Colorado Medical Group LLC Family Medicine Past Accepting new patients

Locations

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

8890 N Union Blvd
Ste 220
Colorado Springs, CO 80920
Phone (719) 574-9191

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

8890 N Union Blvd
Ste 200
Colorado Springs, CO 80920
Phone (719) 548-0700

15909 Jackson Creek Pkwy
Monument, CO 80132
Phone (719) 481-0899

550 W Highway 105
Monument, CO 80132
Phone (719) 481-0161

Interoperability endpoints

  • Direct secure messaging: mklismith119402@westdirect.optum.com

Organizations & group practices 3

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1437231990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15909 JACKSON CREEK PKWY",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801328693",
            "telephone_number": "719-522-1133",
            "fax_number": "719-481-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLISMITH",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0053709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81177836",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "OLDS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monument, CO

Sources for this page

Verify at the official NPI Registry.