NPIMap

Individual provider Active NPI

Kira Miyoko Lebsack, AG-NP

  • Adult Health Nurse Practitioner
  • Wheat Ridge, CO
National Provider Identifier
1457022568
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN.0996961-NP Issued in CO
Practice address
10900 W 44TH Ave Unit 200
Wheat Ridge, CO 80033-2742
Phone
(303) 993-1330
Fax
(303) 647-3647
NPI assigned
Sep 28, 2021
Last updated
Jul 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0996961-NP CO
Acute Care Nurse Practitioner 363LA2100X APN.0996961-NP CO
Adult Health Nurse Practitioner 363LA2200X APN.0996961-NP CO Primary
Registered Nurse 163W00000X RN.0199048 CO

Addresses

Primary practice location

10900 W 44TH Ave Unit 200
Wheat Ridge, CO 80033-2742

Mailing address

10900 W 44TH Ave Unit 200
Wheat Ridge, CO 80033-2742
Phone (303) 993-1330

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
I20211103001530 CO Practitioner - Nurse Practitioner 5698163095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2525 S Downing St
HSPC Hospitalists Pah
Denver, CO 80210-5817
Phone (303) 715-7184

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
78.58
Promoting interoperability
100
Improvement activities
40
Cost
74.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.0199048COMDRegistered Nurse
APN.0996961-NPCOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Sep 1, 2022 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Sep 1, 2022 Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

2525 S Downing St
Denver, CO 80210
Phone (303) 744-2706

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

Interoperability endpoints

  • Direct secure messaging: klebsack1867115@adventhealth.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1457022568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 W 44TH AVE UNIT 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332742",
            "telephone_number": "303-993-1330",
            "fax_number": "303-647-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 W 44TH AVE UNIT 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332742",
            "telephone_number": "303-993-1330",
            "fax_number": "303-647-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBSACK",
        "first_name": "KIRA",
        "middle_name": "MIYOKO",
        "credential": "AG-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0996961-NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "APN.0996961-NP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.0996961-NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0199048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.