NPIMap

Individual provider Active NPI

Amelia Elissa Virostko, MD

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1306010970
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0049964 Issued in CO
Practice address
1635 Blue Spruce Dr
Fort Collins, CO 80524-5427
Phone
(970) 494-4040
Fax
(970) 494-4076
NPI assigned
Apr 15, 2008
Last updated
May 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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.0049964 CO Primary

Addresses

Primary practice location

1635 Blue Spruce Dr
Fort Collins, CO 80524-5427

Mailing address

203 S Rollie Ave
Fort Lupton, CO 80621-1508
Phone (303) 286-4560

Other identifiers 1

IdentifierTypeStateIssuer
00579076MedicaidCO

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
I20120103000480 CO Practitioner - Family Practice 6406022086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Family HealthGroup PAC ID 3173433398, 75 clinicians

Practice addresses (Care Compare)

1635 Blue Spruce Dr
Fort Collins, CO 80524-5427
Phone (970) 494-4040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0049964COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Family Health CurrentSince Jul 9, 2012 Accepting new patients
Salud Family Health CurrentSince Jul 9, 2012 Accepting new patients
Salud Family Health Past Accepting new patients
Salud Family Health Past Accepting new patients

Locations

30 S 20th Ave
Brighton, CO 80601
Phone (303) 655-1950

1635 Blue Spruce Dr
Fort Collins, CO 80524
Phone (970) 494-4040

1115 2nd St
Fort Lupton, CO 80621
Phone (303) 857-2771

203 S Rollie Ave
Fort Lupton, CO 80621
Phone (303) 286-4560

729 E Railroad Ave
Fort Morgan, CO 80701
Phone (970) 867-0300

5995 Iris Pkwy
Frederick, CO 80504
Phone (303) 833-2050

220 E Rogers Rd
Longmont, CO 80501
Phone (303) 776-3250

1410 S 7th Ave
Sterling, CO 80751
Phone (970) 526-2589

911 Robinson Ave
Trinidad, CO 81082
Phone (303) 386-2727

Interoperability endpoints

  • Direct secure messaging: amelia.virostko@sfhc.eclinicaldirectplus.com

Organizations & group practices 4

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1306010970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-286-4560",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 BLUE SPRUCE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805245427",
            "telephone_number": "970-494-4040",
            "fax_number": "970-494-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIROSTKO",
        "first_name": "AMELIA",
        "middle_name": "ELISSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0049964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00579076",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.