Douglas Paul Peller, D.O.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

37826 Issued in CO

Practice address

9141 Grant Street
Suite 240
Thornton, CO 80229

Phone

(303) 920-1015

Fax

(303) 252-1437

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Chicago College of Osteopathy, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trauma and Emergency Subspecialty Surgeons PLLCGroup PAC ID 1951559293, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yuma District Hospital Hospital, Yuma, CO, CCN 061315
• Wray Community District Hospital Hospital, Wray, CO, CCN 061309
• Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Douglas P Peller DO LLC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Thornton, CO
  • NPI 1871620682
  Medicare reassignment NPD Authorized official
• Trauma and Emergency Subspecialty Surgeons PLLC

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Highlands Ranch, CO
  • NPI 1740543933
  Medicare reassignment Care Compare group NPD
• Healthone Clinic Services LLC

  • Rehabilitation Clinic/Center
  • Denver, CO
  • NPI 1609950914
  NPD (past)

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

• Good Samaritan Medical Center, LLC

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1407845035
  Care Compare affiliation
• Wray Community District Hospital

  • Critical Access Hospital
  • Wray, CO
  • NPI 1083640239
  Care Compare affiliation
• Wray Community District Hospital

  • General Practice Physician
  • Wray, CO
  • NPI 1477587202

  Hospital

  Care Compare affiliation
• Yuma District Hospital

  • Critical Access Hospital
  • Yuma, CO
  • NPI 1629074182
  Care Compare affiliation

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1083754600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9141 GRANT STREET, SUITE 240",
            "address_2": "SUITE 240",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80229",
            "telephone_number": "303-920-1015",
            "fax_number": "303-252-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9141 GRANT STREET",
            "address_2": "SUITE 240",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80229",
            "telephone_number": "303-920-1015",
            "fax_number": "303-252-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLER",
        "first_name": "DOUGLAS",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CO",
            "license": "37826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63286271",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Pederson, LPC
• Pedo One, Prof. LLC
• Pedo Three Prof. LLC
• Lorena Pedroza-Madrid, L.AC.
• Deanna Monique Pedroza, O.D.
• Katarina Pelletier, MA CCC-SLP
• Pelvicore Therapeutics, PLLC
• People'S Choice Home Health Care
• Jimica Perea
• Perfect Teeth - East 104TH Avenue P.C.

• Otolaryngology/Facial Plastic Surgery Physician in Thornton, CO
• Providers in Thornton, CO by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.