KIRSTEN DEROODE (PA-C) – Medical Physician Assistant, NPI 1003353178

KIRSTEN DEROODE (PA-C) is a healthcare provider. based in Lakewood, Colorado. specializing in Medical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA0004908 (CO). The NPI Number for KIRSTEN DEROODE (PA-C) is 1003353178

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KIRSTEN DEROODE (PA-C)
NPI
1003353178
Phone
(720) 321-0000
Address
11600 W 2nd Pl
Enumeration Date
26 January 2017
Last Update Date
21 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3036431159
Graduation Year
2016 (10 years ago)
PAC ID
9032496344
Group Practice PAC ID
0941110886
Professional Enrollment ID
I20170515000387
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

Provider Addresses for KIRSTEN DEROODE (PA-C)

  • 11600 W 2nd Pl

    Lakewood, CO 802281527

    Phone: (720) 321-0000

    Fax: (303) 306-4337

    Type: Location

  • 9250 E COSTILLA AVE STE 540

    GREENWOOD VILLAGE, CO 801123648

    Phone: (720) 644-9355

    Type: Mailing

  • 12230 LIONESS WAY

    PARKER, CO 801345603

    Phone: (720) 644-9355

    Type: Location

  • 12605 E 16th Ave

    Aurora, CO 800452545

    Phone: (720) 848-0000

    Type: Location

  • Associates of Otolaryngology, 850, East Harvard Avenue, Rosedale, Denver, Denver County, Colorado, 80210, United States

    #305

    DENVER, CO 802105073

    Phone: (303) 306-4321

    Fax: (303) 306-4337

    Type: Mailing

  • 11600 W 2ND PL

    LAKEWOOD, CO 802281527

    Phone: (720) 321-0000

    Fax: (303) 306-4337

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-05-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170515000387IPhysician AssistantCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80228)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941110886View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YCO
Nurse PractitionerCO
Internal MedicineCO
Physician AssistantCO
Family PracticeCO
Physician AssistantCO
-CO
Family PracticeCO
Internal MedicineCO
N E U R O L O G YCO

Reviews

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Frequently asked questions

Can I cross-check KIRSTEN DEROODE (PA-C) using NPI 1003353178?
NPI 1003353178 belongs to KIRSTEN DEROODE (PA-C); compare other details if you need extra assurance.
Is there an active status for KIRSTEN DEROODE (PA-C)?
For scheduling context, KIRSTEN DEROODE (PA-C) is shown as active in the registry.
What kind of doctor is KIRSTEN DEROODE (PA-C)?
KIRSTEN DEROODE (PA-C) is associated with Medical Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with KIRSTEN DEROODE (PA-C)?
Directory geography for KIRSTEN DEROODE (PA-C) centers on Lakewood, Colorado.
When was this NPI issued?
Enumeration for KIRSTEN DEROODE (PA-C) is noted as January 26, 2017 where the registry provides it.

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