NPIMap

Individual provider Active NPI

Brian Lee Kaiser, D.O.

  • Neurology Physician
  • Fort Collins, CO
National Provider Identifier
1053518670
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DR.0053671 Issued in CO
Practice address
1106 E Prospect Rd
Suite 100
Fort Collins, CO 80525-5304
Phone
(970) 482-4373
Fax
(970) 484-5682
NPI assigned
Jun 28, 2007
Last updated
Mar 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DR.0053671 CO Primary

Addresses

Primary practice location

1106 E Prospect Rd
Suite 100
Fort Collins, CO 80525-5304

Mailing address

1106 E Prospect Rd
Suite 100
Fort Collins, CO 80525-5304
Phone (970) 482-4373

Other identifiers 3

IdentifierTypeStateIssuer
P01363051OtherCOMEDICARE RAILROAD
138363400MedicaidWY
30389551MedicaidCO

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
I20140825001252 CO Practitioner - Neurology 7113145673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Michigan State University College of Osteopathic Medicine, 2007
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)

1024 S Lemay Ave
Uchmg Palliative Care
Fort Collins, CO 80524-3929
Phone (970) 495-8369

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 7, 2014 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 7, 2014 Accepting new patients

Locations

1725 E Boulder St
Ste 101
Colorado Springs, CO 80909
Phone (719) 365-6300

4110 Briargate Pkwy
Ste 140
Colorado Springs, CO 80920
Phone (719) 365-7300

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

1106 E Prospect Rd
Ste 100
Fort Collins, CO 80525
Phone (970) 224-3636

2315 E Harmony Rd
Ste 110
Fort Collins, CO 80528
Phone (970) 212-7600

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

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 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1053518670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 E PROSPECT RD",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255304",
            "telephone_number": "970-482-4373",
            "fax_number": "970-484-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 E PROSPECT RD",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255304",
            "telephone_number": "970-482-4373",
            "fax_number": "970-484-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "BRIAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0053671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01363051",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138363400",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30389551",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.