Individual provider Active NPI

David McCarty, DO

  • Internal Medicine Physician
  • Longmont, CO
National Provider Identifier
1174521058
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19744 Issued in CO
Practice address
815 Panorama Cir
Longmont, CO 80501-4716
Phone
(303) 591-4668
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19744 CO Primary

Addresses

Primary practice location

815 Panorama Cir
Longmont, CO 80501-4716

Mailing address

PO Box 21150
Boulder, CO 80308-4150
Phone (303) 546-9158

Other identifiers 1

IdentifierTypeStateIssuer
01197441MedicaidCO

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
I20100809000224 CO Practitioner - Internal MedicinePractitioner - General Practice 2668505876 Reassigns benefits to 1 organization
Practice locations: Longmont, CO

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19744COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longmont United Hospital 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.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1174521058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21150",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803084150",
            "telephone_number": "303-546-9158",
            "fax_number": "303-546-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 PANORAMA CIR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805014716",
            "telephone_number": "303-591-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTY",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "19744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01197441",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.