NPIMap

Individual provider Active NPI

Lisa Ann Tellier, PA-C

  • Physician Assistant
  • Longmont, CO
National Provider Identifier
1710148911
Registry record updated May 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2605 Issued in CO
Practice address
1760 E Ken Pratt Blvd Ste 302
Longmont, CO 80504-5311
Phone
(303) 684-1900
Fax
(303) 267-4470
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2023

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 2605 CO Primary

Addresses

Primary practice location

1760 E Ken Pratt Blvd Ste 302
Longmont, CO 80504-5311

Mailing address

1760 E Ken Pratt Blvd Ste 302
Longmont, CO 80504-5311
Phone (303) 684-1900

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
I20080924000059 CO Practitioner - Physician Assistant 5890862478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Colorado School of Medicine, Denver, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocky Mountain Cancer Centers LLPGroup PAC ID 7012820533, 131 clinicians

Practice addresses (Care Compare)

1760 E Ken Pratt Boulevard
Suite 301 (RMBS) and Suite 302 (RMCC)
Longmont, CO 80504-5311
Phone (303) 684-1900

3027 N Circle Dr
Colorado Springs, CO 80909-1179
Phone (719) 577-2555

Hospital & facility affiliations

  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
  • Boulder Community Health Hospital, Boulder, CO, CCN 060027
  • Longmont United Hospital Hospital, Longmont, CO, CCN 060003
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Cancer Centers, LLP CurrentSince Jun 23, 2008 Accepting new patients
Rocky Mountain Cancer Centers LLP Physician Assistant Past Accepting new patients
Khalid Chowdhury MD, PC PastSince Feb 12, 2013 Accepting new patients

Locations

3027 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 577-2555

1601 E 19th Ave
Ste 3000
Denver, CO 80218
Phone (303) 388-4876

1800 N Williams St
Ste 200
Denver, CO 80218
Phone (303) 388-4876

7951 E Maplewood Ave
Ste 300
Greenwood Village, CO 80111
Phone (303) 930-7800

1760 E Ken Pratt Blvd
Ste 302
Longmont, CO 80504
Phone (303) 684-1900

2030 Mountain View Ave
Ste 210
Longmont, CO 80501
Phone (303) 684-1900

1760 E Ken Pratt Blvd
Ste 301
Longmont, CO 80504
Phone (300) 368-4190

Interoperability endpoints

  • Direct secure messaging: lisa.tellier@rmcc.ikm.direct-ci.com

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.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684540800000",
    "number": "1710148911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 E KEN PRATT BLVD STE 302",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805045311",
            "telephone_number": "303-684-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E KEN PRATT BLVD STE 302",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805045311",
            "telephone_number": "303-684-1900",
            "fax_number": "303-267-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLIER",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2023-05-20",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.