NPIMap

Individual provider Active NPI

Bernard J Birnbaum, M.D.

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1295772432
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR-44489 Issued in CO
Practice address
1025 Pennock PL
Fort Collins, CO 80524-3257
Phone
(970) 495-8800
Fax
(970) 495-8820
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR-44489 CO Primary

Addresses

Primary practice location

1025 Pennock PL
Fort Collins, CO 80524-3257

Mailing address

1025 Pennock PL
Fort Collins, CO 80524-3257
Phone (970) 495-8800

Other identifiers 1

IdentifierTypeStateIssuer
51155745MedicaidCO

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
I20060627000176 CO Practitioner - Family Practice 3173535648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Health Care IncGroup PAC ID 7618880709, 56 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929
Phone (970) 495-7127

1025 Pennock PL
Fort Collins, CO 80524-3250

Hospital & facility affiliations

  • Banner Home Care Colorado Home health agency, Greeley, CO, CCN 067147
  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR-44489COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care Inc CurrentSince Aug 26, 2006 Accepting new patients
Poudre Valley Health Care Inc. Current Accepting new patients
Poudre Valley Health Care Inc CurrentSince Aug 26, 2006 Accepting new patients

Locations

1025 Pennock Pl
#111
Fort Collins, CO 80524

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1025 Pennock Pl
Ste 114
Fort Collins, CO 80524
Phone (970) 495-8800

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1295772432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRNBAUM",
        "first_name": "BERNARD",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR-44489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51155745",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.