Individual provider Active NPI

Stephen W Cotlar, MD

  • Plastic Surgery Physician
  • Grand Junction, CO
National Provider Identifier
1215913264
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
43223 Issued in CO
Practice address
2635 N 7TH St
Grand Junction, CO 81501-1628
Phone
(970) 298-6307
Fax
(970) 298-7037
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 43223 CO Primary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 43223 CO

Addresses

Primary practice location

2635 N 7TH St
Grand Junction, CO 81501-1628

Mailing address

PO Box 62
Grand Junction, CO 81502-0062
Phone (970) 298-6307

Other identifiers 1

IdentifierTypeStateIssuer
07671059MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413000447 CO Practitioner - Plastic and Reconstructive Surgery 0244219095 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43223COMDUndersea and Hyperbaric Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley View Hospital Association Current Accepting new patients
Valley View Hospital Association CurrentSince Feb 1, 2019 Accepting new patients
Valley View Hospital Association CurrentSince Feb 1, 2019 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Past Accepting new patients
St Mary'S Hospital and Medical Center, Inc Plastic Surgery Past Accepting new patients

Locations

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

2001 N Horseshoe Trl
Silt, CO 81652
Phone (970) 876-5700

Organizations & group practices 6

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1215913264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815020062",
            "telephone_number": "970-298-6307",
            "fax_number": "970-298-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815011628",
            "telephone_number": "970-298-6307",
            "fax_number": "970-298-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTLAR",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CO",
            "license": "43223",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "CO",
            "license": "43223",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07671059",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.