Lesley D Moritz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0001446 Issued in CO

Practice address

5965 Firestone Blvd
Firestone, CO 80504-6607

Phone

(720) 652-7055

Fax

(720) 652-7056

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Platte Valley Emergency Physicians, PC

  • Emergency Medicine Physician
  • Brighton, CO
  • NPI 1508836198
  NPD (past)
• Uchealth Community Services

  • Physical Therapist
  • Englewood, CO
  • NPI 1841740693
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1760512503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011406",
            "telephone_number": "720-745-8030",
            "fax_number": "720-745-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 FIRESTONE BLVD",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805046607",
            "telephone_number": "720-652-7055",
            "fax_number": "720-652-7056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Main St",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805011406",
            "country_code": "US",
            "telephone_number": "720-745-8030",
            "fax_number": "720-745-8031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Exempla Cir",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800263370",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORITZ",
        "first_name": "LESLEY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0001446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "016912",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87386763",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amanda Moon
• Tristin Moreland, M.S., CCC-SLP
• Erin Daphne Christena Moulin, PHARMD
• My Local Colorado Dental Practice, LLC
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• Melissa Naughton
• Nicole Newsom

• Physician Assistant in Firestone, CO
• Providers in Firestone, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.