Kristi Lynn Paetzel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0002494 Issued in CO

Practice address

4840 Larimer Pkwy BLDG 1
Johnstown, CO 80534-9012

Phone

(970) 624-2830

Fax

(970) 624-2836

NPI assigned

Oct 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristi Lynn Kloberdanz Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131
• Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Banner Medical Group Greeley LLC

  • Multi-Specialty Clinic/Center
  • Johnstown, CO
  • NPI 1386817880
  NPD (past)
• Big Thompson Medical Group Inc

  • Family Medicine Physician
  • Loveland, CO
  • NPI 1720011786

  Physician Assistant

  NPD (past)
• Poudre Valley Medical Group, LLC

  • Family Medicine Physician
  • Johnstown, CO
  • NPI 1699388934
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1104262286
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Loveland, CO
  • NPI 1750392304
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1780243055
  Care Compare affiliation
• Uchealth Greeley Hospital

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1780183145
  Care Compare affiliation

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1508055641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 LARIMER PKWY BLDG 1",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805349012",
            "telephone_number": "970-624-2830",
            "fax_number": "970-624-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 LARIMER PKWY BLDG 1",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805349012",
            "telephone_number": "970-624-2830",
            "fax_number": "970-624-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAETZEL",
        "first_name": "KRISTI",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0002494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42422540",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "KLOBERDANZ",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Johnstown, CO
• Providers in Johnstown, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.