Individual provider Active NPI

Elizabeth Fitzgerald Kane, PNP

  • Pediatric Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1689812612
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN.0010096-NP Issued in CO
Practice address
3292 Peoria St
Aurora, CO 80010-1517
Phone
(303) 343-6130
Fax
(303) 344-0664
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 6623899 NY
Pediatric Nurse Practitioner 363LP0200X APN.0010096-NP CO Primary
Pediatric Registered Nurse 163WP0200X RN.0191197 CO
Pediatric Nurse Practitioner 363LP0200X RXN.0001142-NP CO

Addresses

Primary practice location

3292 Peoria St
Aurora, CO 80010-1517

Mailing address

3701 S Broadway
Englewood, CO 80113-3611
Phone (303) 360-6276

Other identifiers 1

IdentifierTypeStateIssuer
59257521MedicaidCO

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
I20230118001235 CO Practitioner - Nurse Practitioner 9335402833 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RXN.0001142-NPCOMDPediatric Nurse Practitioner
6623899NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Community Provider Network Inc CurrentSince Oct 7, 2022 Accepting new patients
Metro Community Provider Network Inc Current Accepting new patients
Metro Community Provider Network, Inc. CurrentSince Oct 7, 2022 Accepting new patients

Locations

10680 Del Mar Pkwy
Aurora, CO 80010
Phone (303) 761-2153

3292 Peoria St
Aurora, CO 80010
Phone (303) 343-6130

2255 S Oneida St
Denver, CO 80224

3701 S Broadway
Englewood, CO 80113

17866 Cottonwood Dr
Parker, CO 80134
Phone (303) 205-6899

Organizations & group practices 3

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": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1689812612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 S BROADWAY",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133611",
            "telephone_number": "303-360-6276",
            "fax_number": "303-467-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 PEORIA ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800101517",
            "telephone_number": "303-343-6130",
            "fax_number": "303-344-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "ELIZABETH",
        "middle_name": "FITZGERALD",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "6623899",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0010096-NP",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CO",
            "license": "RN.0191197",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "RXN.0001142-NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59257521",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.