Individual provider Active NPI

Stefan Iverson, DO

  • Surgery Physician
  • Salida, CO
National Provider Identifier
1053948646
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
75732 Issued in CO
Practice address
1000 Rush Dr
Salida, CO 81201-9627
Phone
(719) 530-2000
NPI assigned
Mar 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 75732 CO Primary

Addresses

Primary practice location

1000 Rush Dr
Salida, CO 81201-9627

Mailing address

1101 Pinon Dr
Poncha Springs, CO 81242-5084

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251016000827 CO Practitioner - General Surgery 6901393628 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salida Hospital DistrictGroup PAC ID 3577451152, shared by 9 NPIs, 100 clinicians

Practice addresses (Care Compare)

1000 Rush Dr
Salida, CO 81201-9627
Phone (719) 530-2477

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75732COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salida Hospital District CurrentSince Sep 15, 2025 Accepting new patients
Salida Hospital District CurrentSince Jul 1, 2025 Accepting new patients
Salida Hospital District Current Accepting new patients
Salida Hospital District CurrentSince Jul 1, 2025 Accepting new patients
Salida General Surgery, PLLC Surgery CurrentSince Dec 7, 2025 Accepting new patients

Locations

1000 Rush Dr
Salida, CO 81201
Phone (719) 530-2265

Interoperability endpoints

  • Direct secure messaging: stefan.iverson@hca3.eclinicaldirectplus.com

Organizations & group practices 5

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 1

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1053948646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PINON DR",
            "city": "PONCHA SPRINGS",
            "state": "CO",
            "postal_code": "812425084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RUSH DR",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812019627",
            "telephone_number": "719-530-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "STEFAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "75732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salida, CO

Sources for this page

Verify at the official NPI Registry.