NPIMap

Individual provider Active NPI

Ian Sebastian Bach, MD

  • Family Medicine Physician
  • Parker, CO
National Provider Identifier
1003895293
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35490 Issued in CO
Practice address
19964 Hilltop Rd Ste a
Parker, CO 80134-7316
Phone
(303) 841-2212
Fax
(303) 841-4716
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35490 CO Primary

Addresses

Primary practice location

19964 Hilltop Rd Ste a
Parker, CO 80134-7316

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4123

Other identifiers 12

IdentifierTypeStateIssuer
01354901MedicaidCO
04020541MedicaidCO
276029OtherCOCIGNA
84136530238OtherCOPACIFICARE
7201056OtherCOAETNA
RO103008OtherCOGROUP ANTHEM BCBS
84136530263OtherCOPACIFICARE PPO
080186089OtherCORAILROAD MEDICARE #
BA645053OtherCOANTHEM BCBS
1003895293OtherCONPI #
1215981634OtherCOGROUP NPI #
841365302036OtherCORKY MTN HMO

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
I20050117000332 CO Practitioner - Family Practice 7911956982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

19964 Hilltop Rd
Suite a
Parker, CO 80134-7316
Phone (303) 841-2212

Hospital & facility affiliations

  • Uchealth Highlands Ranch Hospital Hospital, Highlands Ranch, CO, CCN 060132
  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35490COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 1, 2014 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 20, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 1, 2014 Accepting new patients
Intermountain Medical Group Denver, LLC Family Medicine Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 20, 2023 Accepting new patients
Rocky Mountain Primary Care , PC Family Medicine Past Accepting new patients

Locations

12169 Sheridan Blvd
Broomfield, CO 80020
Phone (303) 439-0169

500 Eldorado Blvd
Ste 6250
Broomfield, CO 80021
Phone (303) 272-0750

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

19964 Hilltop Rd
Parker, CO 80134

19964 Hilltop Rd
Ste A
Parker, CO 80134
Phone (303) 841-2212

Organizations & group practices 6

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1003895293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4123",
            "fax_number": "970-624-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19964 HILLTOP RD STE A",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347316",
            "telephone_number": "303-841-2212",
            "fax_number": "303-841-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "IAN",
        "middle_name": "SEBASTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "35490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01354901",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04020541",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "276029",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "84136530238",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7201056",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ANTHEM BCBS",
            "identifier": "RO103008",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE PPO",
            "identifier": "84136530263",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "080186089",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "BA645053",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1003895293",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI #",
            "identifier": "1215981634",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RKY MTN HMO",
            "identifier": "841365302036",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.