NPIMap

Individual provider Active NPI

Charles A Gottlob, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Golden, CO
National Provider Identifier
1003878083
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
34965 Issued in CO
Practice address
660 Golden Ridge Rd
Suite 250
Golden, CO 80401-9541
Phone
(303) 233-1223
Fax
(303) 233-8755
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 34965 CO
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 34965 CO Primary

Addresses

Primary practice location

660 Golden Ridge Rd
Suite 250
Golden, CO 80401-9541

Mailing address

660 Golden Ridge Rd
Suite 250
Golden, CO 80401-9541
Phone (303) 233-1223

Other identifiers 1

IdentifierTypeStateIssuer
77722272MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101213000357 CO Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 6901797281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of California, Geffen School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Panorama Orthopedics and Spine Center PCGroup PAC ID 8426961087, 316 clinicians

Practice addresses (Care Compare)

660 Golden Ridge Rd
Suite 250
Golden, CO 80401-9541
Phone (303) 233-1223

Hospital & facility affiliations

  • Orthocolorado Hosp at St Anthony Med Campus Hospital, Lakewood, CO, CCN 060124
  • Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015

Merit-based Incentive Payment System (MIPS)

Final score
96.68 of 100Reported as group
Quality
96.09
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34965COMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Panorama Orthopedics & Spine Center, PC CurrentSince Jul 1, 2001 Accepting new patients
Panorama Orthopedics and Spine Center PC Orthopaedic Surgery Current Accepting new patients
Panorama Orthopedics & Spine Center, PC CurrentSince Jul 1, 2001 Accepting new patients

Locations

660 Golden Ridge Rd
Ste 250
Golden, CO 80401
Phone (303) 274-7321

640 Plaza Dr
Ste 130
Highlands Ranch, CO 80129

Networks

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

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1003878083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 GOLDEN RIDGE RD",
            "address_2": "SUITE 250",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019541",
            "telephone_number": "303-233-1223",
            "fax_number": "303-233-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 GOLDEN RIDGE RD",
            "address_2": "SUITE 250",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019541",
            "telephone_number": "303-233-1223",
            "fax_number": "303-233-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLOB",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "34965",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CO",
            "license": "34965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77722272",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

Verify at the official NPI Registry.