Individual provider Active NPI

W Peter Vellman, MD

  • Emergency Medicine Physician
  • Lakewood, CO
National Provider Identifier
1265405930
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
24110 Issued in CO
Practice address
11600 W 2ND PL
St. Anthony Hospital, Emergency Dept.
Lakewood, CO 80228-1527
Phone
(720) 321-4161
Fax
(720) 321-4165
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 24110 CO Primary

Addresses

Primary practice location

11600 W 2ND PL
St. Anthony Hospital, Emergency Dept.
Lakewood, CO 80228-1527

Mailing address

PO Box 5788
Denver, CO 80217-5788
Phone (303) 202-1280

Other identifiers 10

IdentifierTypeStateIssuer
PENDINGMedicaidNE
Z3272MedicaidUT
203206023101OtherPACIFICARE SECURE HORIZONS
122713100MedicaidWY
610854400OtherUS DEPARTMENT OF LABOR
P00181908OtherRR MEDICARE
129035MedicaidAZ
200390020AMedicaidKS
01241108MedicaidCO
S2054MedicaidNM

Other names 1

  • William P Vellman Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24110COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Serio South Carolina, LLC Emergency Medicine PastSince Jun 1, 2010 Accepting new patients
Apex Emergency Group, Inc Emergency Medicine Past Accepting new patients
Stadium Medical, Inc. PastSince Oct 20, 2009 Accepting new patients

Organizations & group practices 3

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1265405930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5788",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175788",
            "telephone_number": "303-202-1280",
            "fax_number": "303-202-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 W 2ND PL",
            "address_2": "ST. ANTHONY HOSPITAL, EMERGENCY DEPT.",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281527",
            "telephone_number": "720-321-4161",
            "fax_number": "720-321-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELLMAN",
        "first_name": "W",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "24110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z3272",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE SECURE HORIZONS",
            "identifier": "203206023101",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122713100",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "610854400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00181908",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129035",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200390020A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01241108",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S2054",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "VELLMAN",
            "middle_name": "P",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.