NPIMap

Individual provider Active NPI

Michael D Vaardahl, DPM

  • Podiatrist
  • Greeley, CO
National Provider Identifier
1265429369
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
596 Issued in CO
Practice address
1931 65TH Ave
Ste a
Greeley, CO 80634-7945
Phone
(970) 351-0900
Fax
(970) 351-0940
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 596 CO Primary

Addresses

Primary practice location

1931 65TH Ave
Ste a
Greeley, CO 80634-7945

Mailing address

1931 65TH Ave
Ste a
Greeley, CO 80634-7945
Phone (970) 351-0900

Other identifiers 1

IdentifierTypeStateIssuer
16254031MedicaidCO

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
I20100820000971 CO Practitioner - Podiatry 9638203938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Center of the Rockies LLCGroup PAC ID 9931537693, 9 clinicians

Practice addresses (Care Compare)

1931 65TH Ave
Suite a
Greeley, CO 80634-7946
Phone (970) 351-0900

Hospital & facility affiliations

  • Banner Home Care Colorado Home health agency, Greeley, CO, CCN 067147
  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • East Morgan County Hospital Hospital, Brush, CO, CCN 061303

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue114
Removal of skin lesions1-10
Removal of nail tissue44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Center of the Rockies LLC Podiatrist CurrentSince Jan 1, 2020 Accepting new patients
Foot and Ankle Center of the Rockies LLC Podiatrist CurrentSince Apr 1, 2020 Accepting new patients

Locations

4600 Hale Pkwy
Ste 460
Denver, CO 80220
Phone (303) 321-4477

1931 65th Ave
Ste A
Greeley, CO 80634
Phone (970) 351-0900

1305 Sumner St
Unit 200
Longmont, CO 80501
Phone (303) 772-3232

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1265429369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 65TH AVE",
            "address_2": "STE A",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347945",
            "telephone_number": "970-351-0900",
            "fax_number": "970-351-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 65TH AVE",
            "address_2": "STE A",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347945",
            "telephone_number": "970-351-0900",
            "fax_number": "970-351-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAARDAHL",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16254031",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.