Individual provider Active NPI

Lisa Rothgery, MD

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1780730317
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0046058 Issued in CO
Practice address
300 S Jackson St
Suite 340
Denver, CO 80209-3176
Phone
(303) 316-0416
Fax
(303) 316-0421
NPI assigned
Jan 26, 2007
Last updated
Feb 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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 TL-1877 CO
Family Medicine Physician 207Q00000X DR.0046058 CO Primary

Addresses

Primary practice location

300 S Jackson St
Suite 340
Denver, CO 80209-3176

Mailing address

300 S Jackson St
Suite 340
Denver, CO 80209-3176
Phone (303) 316-0416

Other identifiers 1

IdentifierTypeStateIssuer
07220511MedicaidCO

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
I20090629000035 CO Practitioner - Family Practice 2961559331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1445 S Pearl St
Denver, CO 80210-2226
Phone (303) 600-3699

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL-1877COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Pearl Family Medicine PC Family Medicine CurrentSince Dec 29, 2021 Accepting new patients
Portercare Adventist Health System CurrentSince Sep 1, 2010 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Sep 1, 2010 Accepting new patients

Locations

1445 S Pearl St
Denver, CO 80210
Phone (303) 600-3699

300 S Jackson St
Ste 340
Denver, CO 80209
Phone (303) 316-0416

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

19284 Cottonwood Dr
Ste 201
Parker, CO 80138
Phone (303) 269-2626

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23883/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lisa.rothgery.1@23883.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1780730317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST",
            "address_2": "SUITE 340",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093176",
            "telephone_number": "303-316-0416",
            "fax_number": "303-316-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST",
            "address_2": "SUITE 340",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093176",
            "telephone_number": "303-316-0416",
            "fax_number": "303-316-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHGERY",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL-1877",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0046058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07220511",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.