NPIMap

Individual provider Active NPI

Daniel Jonathan Freese, D.O.

  • Gastroenterology Physician
  • Longmont, CO
National Provider Identifier
1144200296
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
42783 Issued in CO
Practice address
1925 Mountain View Ave
Longmont, CO 80501-3128
Phone
(303) 776-1234
Fax
(720) 494-3107
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 42783 CO Primary
Gastroenterology Physician 207RG0100X A-1716-12 NM

Addresses

Primary practice location

1925 Mountain View Ave
Longmont, CO 80501-3128

Mailing address

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

Other identifiers 3

IdentifierTypeStateIssuer
02073048MedicaidNM
266636YM5AOtherNMMEDICARE- LMG
68473711MedicaidCO

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
I20050302000613 CO Practitioner - GastroenterologyPractitioner - Internal Medicine 9537112438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
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)

1750 E Ken Pratt Blvd
Uchealth
Longmont, CO 80504-5311
Phone (970) 237-7848

1760 E Ken Pratt Blvd
Longmont, CO 80504-5311

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Uchealth Broomfield Hospital Hospital, Broomfield, CO, CCN 060129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy71
Upper gastrointestinal (GI) endoscopy for acid reflux77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42783COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Nov 23, 2015 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

1925 Mountain View Ave
Longmont, CO 80501
Phone (303) 776-1234

1925 Mountain View Ave
Fl 3
Longmont, CO 80501
Phone (720) 494-3119

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 and National Provider Directory roles.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1144200296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013128",
            "telephone_number": "303-776-1234",
            "fax_number": "720-494-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013128",
            "telephone_number": "303-776-1234",
            "fax_number": "720-494-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREESE",
        "first_name": "DANIEL",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "42783",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "A-1716-12",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02073048",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- LMG",
            "identifier": "266636YM5A",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68473711",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.