NPIMap

Individual provider Active NPI

Kellie Hasbrook, PA

  • Physician Assistant
  • Louisville, CO
National Provider Identifier
1619867694
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0009235 Issued in CO
Practice address
363 Centennial Pkwy Ste 220
Louisville, CO 80027-1619
Phone
(888) 374-5066
Fax
(719) 623-0165
NPI assigned
Jul 9, 2025
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0009235 CO Primary

Addresses

Primary practice location

363 Centennial Pkwy Ste 220
Louisville, CO 80027-1619

Mailing address

363 Centennial Pkwy Ste 220
Louisville, CO 80027-1619
Phone (888) 374-5066

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
I20250903004254 CO Practitioner - Physician Assistant 2769984343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisdom Health PCGroup PAC ID 4284762501, 11 clinicians

Practice addresses (Care Compare)

2919 Valmont Rd
Suite 204
Boulder, CO 80301-1350
Phone 3039381110512

350 Ponca PL
Boulder, CO 80303-3828
Phone (303) 938-1110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0009235COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kellie.hasbrook@96713091579908.direct.elationemr.com

Organizations & group practices 2

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1619867694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 CENTENNIAL PKWY STE 220",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271619",
            "telephone_number": "888-374-5066",
            "fax_number": "719-623-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 CENTENNIAL PKWY STE 220",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271619",
            "telephone_number": "888-374-5066",
            "fax_number": "719-623-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASBROOK",
        "first_name": "KELLIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0009235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

Verify at the official NPI Registry.