NPIMap

Individual provider Active NPI

Paul A Sandoval, MD

  • Anesthesiology Physician
  • Fort Collins, CO
National Provider Identifier
1043447667
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
51954 Issued in CO
Practice address
3702 Automation Way Ste 103
Fort Collins, CO 80525-5738
Phone
(970) 224-2985
Fax
(970) 223-1118
NPI assigned
Jun 22, 2009
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL3374 CO
Anesthesiology Physician 207L00000X 51954 CO Primary

Addresses

Primary practice location

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738

Mailing address

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738
Phone (970) 224-2985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130919000605 CO Practitioner - Anesthesiology 8123262847 Reassigns benefits to 1 organization
I20220314000805 WY Practitioner - Anesthesiology 8123262847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Colorado School of Medicine, Aurora, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Colorado Anesthesia Professionals PLLCGroup PAC ID 6800878760, 155 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Ncap PLLC
Fort Collins, CO 80524-3929
Phone (970) 495-7000

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-2985

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51954COMDAnesthesiology Physician
TL3374COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ncap Imh, LLC Anesthesiology CurrentSince Dec 10, 2021 Accepting new patients
Northern Colorado Anesthesia Professionals PLLC Anesthesiology CurrentSince Aug 7, 2013 Accepting new patients

Locations

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1236 E Elizabeth St
Ste 1
Fort Collins, CO 80524
Phone (970) 236-2628

3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 495-6201

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1043447667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY STE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255738",
            "telephone_number": "970-224-2985",
            "fax_number": "970-223-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY STE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255738",
            "telephone_number": "970-224-2985",
            "fax_number": "970-223-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL3374",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "51954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.