Individual provider Active NPI

Matthew Diehl Hinderland, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Colorado Springs, CO
National Provider Identifier
1003050899
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
707 Issued in CO
Practice address
1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945
Phone
(719) 488-4664
Fax
(719) 488-4667
NPI assigned
Apr 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 01521 MD
Foot & Ankle Surgery Podiatrist 213ES0103X 707 CO Primary

Addresses

Primary practice location

1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945

Mailing address

1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945
Phone (719) 488-4664

Other identifiers 1

IdentifierTypeStateIssuer
4085040MedicaidCO

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140709000712 CO Practitioner - Podiatry 5092962381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Institute of Colorado PCGroup PAC ID 5395066013, 4 clinicians

Practice addresses (Care Compare)

1465 Kelly Johnson Blvd
Suite 100
Colorado Springs, CO 80920-3945
Phone (719) 488-4664

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue30
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01521MDMDPodiatrist
707COMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Institute of Colorado, PC Podiatrist CurrentSince May 12, 2015 Accepting new patients
Nassau Advanced Foot & Ankle, a Professional Limited Liability Company Foot & Ankle Surgery Past Accepting new patients

Locations

6475 Wall St
Ste 100
Colorado Springs, CO 80918
Phone (719) 488-4664

1465 Kelly Johnson Blvd
Ste 100
Colorado Springs, CO 80920
Phone (719) 422-6872

Networks

  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • NM HMO C-SNP
  • CO HMO D-SNP
  • CO HMO

Organizations & group practices 2

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1003050899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203945",
            "telephone_number": "719-488-4664",
            "fax_number": "719-488-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203945",
            "telephone_number": "719-488-4664",
            "fax_number": "719-488-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINDERLAND",
        "first_name": "MATTHEW",
        "middle_name": "DIEHL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-24",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01521",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4085040",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.