NPIMap

Individual provider Active NPI

Matthew Lee Robertson, MD

  • Otolaryngology Physician
  • Fort Collins, CO
National Provider Identifier
1245208214
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
44300 Issued in CO
Practice address
1120 E Elizabeth St
#F-101
Fort Collins, CO 80524-4044
Phone
(970) 221-1177
NPI assigned
Mar 8, 2006
Last updated
Nov 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 44300 CO Primary

Addresses

Primary practice location

1120 E Elizabeth St
#F-101
Fort Collins, CO 80524-4044

Mailing address

5421 Northern Lights Dr
Fort Collins, CO 80528-4439
Phone (970) 377-0277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060714000053 CO Practitioner - Otolaryngology 1951314020 Reassigns benefits to 1 organization
I20190611000052 WY Practitioner - Otolaryngology 1951314020

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Cincinnati College of Medicine and Surgery, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Ear Nose and Throat PCGroup PAC ID 9436127032, 25 clinicians

Practice addresses (Care Compare)

1120 E Elizabeth St
Suite F101
Fort Collins, CO 80524-4044
Phone (970) 221-1177

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44300COMDOtolaryngology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1245208214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 NORTHERN LIGHTS DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805284439",
            "telephone_number": "970-377-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E ELIZABETH ST",
            "address_2": "#F-101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244044",
            "telephone_number": "970-221-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MATTHEW",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "44300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.