NPIMap

Individual provider Active NPI

Denise Sharen Kawecki, FNP-C

  • Nurse Practitioner
  • Erie, CO
National Provider Identifier
1528284031
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0004990-NP Issued in CO
Practice address
101 Erie Pkwy Ste 201E
Erie, CO 80516-4072
Phone
(303) 415-8820
Fax
(303) 938-3499
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN.0164963 CO
Nurse Practitioner 363L00000X APN.0004990-NP CO Primary

Addresses

Primary practice location

101 Erie Pkwy Ste 201E
Erie, CO 80516-4072

Mailing address

5450 Western Ave
Suite B
Boulder, CO 80301-2709
Phone (303) 415-8820

Other identifiers 1

IdentifierTypeStateIssuer
17331846MedicaidCO

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
I20070705000302 CO Practitioner - Nurse Practitioner 8628178654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

101 Erie Pkwy
Suite 201C
Erie, CO 80516-4072
Phone (303) 415-5816

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0004990-NPCOMDNurse Practitioner
RN.0164963COMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince May 1, 2007 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince May 1, 2007 Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

5450 Western Ave
Ste B
Boulder, CO 80301

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

16677 Lowell Blvd
Broomfield, CO 80023
Phone (303) 415-4045

101 Erie Pkwy
Ste 201E
Erie, CO 80516
Phone (303) 415-8820

101 Erie Pkwy
Ste 201C
Erie, CO 80516
Phone (303) 415-5816

101 Erie Pkwy
Ste 201
Erie, CO 80516
Phone (303) 415-5813

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 and National Provider Directory roles.

Hospital & facility affiliations 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1528284031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "address_2": "SUITE B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-8820",
            "fax_number": "303-938-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ERIE PKWY STE 201E",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805164072",
            "telephone_number": "303-415-8820",
            "fax_number": "303-938-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWECKI",
        "first_name": "DENISE",
        "middle_name": "SHAREN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "RN.0164963",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0004990-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17331846",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, CO

Sources for this page

Verify at the official NPI Registry.