Individual provider Active NPI

Bethany R Lombardo, AGACNP-C

  • Acute Care Nurse Practitioner
  • Lakewood, CO
National Provider Identifier
1508591801
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0997747 Issued in CO
Practice address
11700 W 2ND PL
Mob 2 Ste 210
Lakewood, CO 80228-1716
Phone
(720) 321-8080
NPI assigned
Jul 20, 2022
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0997747 CO Primary
Adult Health Nurse Practitioner 363LA2200X 0997747 CO

Addresses

Primary practice location

11700 W 2ND PL
Mob 2 Ste 210
Lakewood, CO 80228-1716

Mailing address

6614 Nelson St
Arvada, CO 80004-1483
Phone (720) 891-3074

Other names 1

  • Bethany R Moore Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221103000082 CO Practitioner - Nurse Practitioner 7810364957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

11700 W 2ND PL
210 Saas Gen Surg Sah
Lakewood, CO 80228-1716
Phone (720) 321-8080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0997747COMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Oct 1, 2022 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 1, 2022 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

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

11700 W 2nd Pl
Ste 210
Lakewood, CO 80228
Phone (720) 321-8080

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

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 4

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": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1508591801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 NELSON ST",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800041483",
            "telephone_number": "720-891-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 W 2ND PL",
            "address_2": "MOB 2 STE 210",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281716",
            "telephone_number": "720-321-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARDO",
        "first_name": "BETHANY",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "AGACNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "0997747",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "0997747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "MOORE",
            "middle_name": "R",
            "credential": "AGACNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.