NPIMap

Lisa Dettmer, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Aurora, CO

NPI 1629468665 · NPPES record last updated May 31, 2018

Key facts

NPI
1629468665
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
0993723 (CO)
Practice address
12605 E 16TH Ave
Aurora, CO 80045
Phone
(720) 848-0000
NPI assigned
Jan 29, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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 28

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

View all 28

Medicare Care Compare profile

Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians Incorporated (3,189 clinicians)
Physician Anesthesia Services PC (112 clinicians)

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

12905 W 40TH Ave
The Surgery Ctr at Lutheran
Golden, CO 80401-2790
Phone (303) 301-7700

12911 W 40TH Ave
Golden, CO 80401-2696
Phone (303) 425-4500

1500 Park Central Dr
Highlands Ranch, CO 80129-6688
Phone (720) 516-1000

3455 Lutheran Pkwy
Wheat Ridge, CO 80033-6028
Phone (303) 422-9438

7809 W 38TH Ave
100 Clear Creek Surgery
Wheat Ridge, CO 80033-6183
Phone (303) 422-5555

Hospital & facility affiliations

  • Uchealth Highlands Ranch Hospital Hospital · Highlands Ranch, CO · CCN 060132
  • University of Colorado Hospital Authority Hospital · Aurora, CO · CCN 060024

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180525000862 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527386994 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0993723COMDCertified Registered Nurse Anesthetist
0001237080VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated Current
since Jun 1, 2018		 Accepting new patients
University Physicians Incorporated Anesthesiology Current Accepting new patients
University Physicians, Incorporated Current
since Jun 1, 2018		 Accepting new patients
Physician Anesthesia Services PC Anesthesiology Current
since Dec 29, 2024		 Accepting new patients
University Physicians, Incorporated Past Accepting new patients

Locations

1635 Aurora Ct
Aurora, CO 80045
Phone (720) 848-1060

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

12605 E 16th Ave
#B113
Aurora, CO 80045
Phone (720) 848-4000

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

Dept 1061
Denver, CO 80256

100 Cook St
Ste 500
Denver, CO 80206
Phone (720) 516-9373

175 Inverness Dr W
Ste 400
Englewood, CO 80112
Phone (720) 516-9916

175 Inverness Dr W
Ste 200
Englewood, CO 80112
Phone (303) 469-3182

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0001237080 VA
Certified Registered Nurse Anesthetist 367500000X 0993723 CO Yes

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 31, 2018.

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1629468665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80045",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMER",
        "first_name": "LISA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001237080",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "0993723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

All providers in Aurora, CO · Certified Registered Nurse Anesthetist in Colorado

Sources for this page

Verify at the official NPI Registry.