Individual provider Active NPI

Andrea Kathleen Sotelo, MD

  • Anatomic Pathology Physician
  • Denver, CO
National Provider Identifier
1104894252
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
42674 Issued in CO
Practice address
6116 E Warren Ave
Denver, CO 80222-5703
Phone
(303) 512-0888
Fax
(303) 512-2268
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 42674 CO Primary

Addresses

Primary practice location

6116 E Warren Ave
Denver, CO 80222-5703

Mailing address

103 Continental PL
Ste 400
Brentwood, TN 37027-1041
Phone (615) 916-3200

Other identifiers 5

IdentifierTypeStateIssuer
0156791MedicaidMT
83357076MedicaidNM
Z2990MedicaidUT
425420100MedicaidMN
03106322MedicaidCO

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
I20051118000269 CO Practitioner - Pathology 2769401710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Colorado School of Medicine, Denver, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthone Irl Pathology Services LLCGroup PAC ID 4082970199, 22 clinicians

Practice addresses (Care Compare)

1719 E 19TH Ave
Denver, CO 80218-1235
Phone (720) 754-6851

Hospital & facility affiliations

  • HCA HealthOne Presbyterian St. Lukes Hospital, Denver, CO, CCN 060014
  • HCA Healthone Rose Hospital, Denver, CO, CCN 060032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42674COMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthone Irl Pathology Services, LLC Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1104894252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CONTINENTAL PL",
            "address_2": "STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271041",
            "telephone_number": "615-916-3200",
            "fax_number": "615-658-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 E WARREN AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802225703",
            "telephone_number": "303-512-0888",
            "fax_number": "303-512-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTELO",
        "first_name": "ANDREA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CO",
            "license": "42674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156791",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83357076",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z2990",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425420100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03106322",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.