Individual provider Active NPI

Lisa Naomi Mettler, M.D.

  • Family Medicine Physician
  • Littleton, CO
National Provider Identifier
1922428846
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0057209 Issued in CO
Practice address
5257 S Wadsworth Blvd
Littleton, CO 80123-2228
Phone
(303) 338-4545
NPI assigned
Apr 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TL.0005192 CO
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DR.0057209 CO Primary

Addresses

Primary practice location

5257 S Wadsworth Blvd
Littleton, CO 80123-2228

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other practice location 1

11600 W 2nd Pl
Lakewood, CO 80228-1527
Phone (720) 321-0000

Other practice location 2

16280 W 64th Ave
Arvada, CO 80007-7413
Phone (720) 898-1110

Other identifiers 2

IdentifierTypeStateIssuer
9000150153MedicaidCO
029049OtherCOKAISER 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
I20170805000221 CO Practitioner - Family PracticePractitioner - Hospitalist 7810268067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
University of Colorado School of Medicine, Denver, 2014
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)

5257 S Wadsworth Boulevard
Kaiser Permanente Southwest Medical
Littleton, CO 80123-2228
Phone (303) 338-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL.0005192COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. CurrentSince Nov 9, 2020 Accepting new patients

Locations

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

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

5257 S Wadsworth Blvd
Littleton, CO 80123
Phone (303) 972-5010

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1922428846",
    "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": "5257 S WADSWORTH BLVD",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801232228",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 W 2nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281527",
            "country_code": "US",
            "telephone_number": "720-321-0000",
            "fax_number": "720-321-1759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16280 W 64th Ave",
            "address_purpose": "LOCATION",
            "city": "Arvada",
            "state": "CO",
            "postal_code": "800077413",
            "country_code": "US",
            "telephone_number": "720-898-1110",
            "fax_number": "720-898-1113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METTLER",
        "first_name": "LISA",
        "middle_name": "NAOMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL.0005192",
            "primary": false
        },
        {
            "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": "DR.0057209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000150153",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029049",
            "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": "5257 S Wadsworth Blvd",
            "city": "Littleton",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801232228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.