Individual provider Active NPI

Lindsey Kae Gerdes, D.O.

  • Family Medicine Physician
  • Greeley, CO
National Provider Identifier
1679865091
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
052024 Issued in CO
Practice address
2429 35TH Ave
Greeley, CO 80634-4171
Phone
(303) 338-4545
NPI assigned
May 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 052024 CO Primary

Addresses

Primary practice location

2429 35TH Ave
Greeley, CO 80634-4171

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other identifiers 2

IdentifierTypeStateIssuer
17256771MedicaidCO
024328OtherCOKAISER COMMERCIAL NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141020002513 CO Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 7012159809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

10350 E Dakota Ave
Denver, CO 80247-1314

10350 E Dakota Avenue B
Kaiser Permanente High
Denver, CO 80247-1314
Phone (303) 338-4545

10350 E Dakota Avenue C
Kaiser Permanente Highline Chemical
Denver, CO 80247-1314
Phone (303) 338-4545

2429 35TH Ave
Greeley, CO 80634-4171
Phone (303) 338-4545

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
052024COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. CurrentSince Aug 4, 2014 Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

2429 35th Ave
Greeley, CO 80634
Phone (303) 326-6717

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1679865091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2429 35TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344171",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDES",
        "first_name": "LINDSEY",
        "middle_name": "KAE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-03",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "052024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17256771",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "024328",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2429 35th Ave",
            "city": "Greeley",
            "state": "CO",
            "country_code": "US",
            "postal_code": "806344171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.