Mountain Vista Orthopaedic Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0214 Issued in CO

Legal business name

MOUNTAIN VISTA ORTHOPAEDIC SURGERY CENTER, LLC

Practice address

5890 W 13TH St Ste 102
Greeley, CO 80634-4821

Phone

(970) 922-3844

Fax

(970) 703-9039

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Todd Werner

Title

Division President

Phone

(602) 747-4000

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Listed as

Banner Health Mountain Vista Surgery CenterCCN 06C0001086

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Banner Health

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1336268754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122702",
            "telephone_number": "602-747-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 W 13TH ST STE 102",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344821",
            "telephone_number": "970-922-3844",
            "fax_number": "970-703-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VISTA ORTHOPAEDIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "DIVISION PRESIDENT",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CO",
            "license": "0214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79826776",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "607473700",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evelyne Mae Moulet
• Laura Moulton, M.A., LPC, NCC
• Mary Moulton, OTR
• Mountain Home Health Care Inc.
• Mountain Vista Imaging LLC
• Mountain Vista Orthopaedics
• Mountainside Counseling, PLLC
• Robert Muehlberger, LPC
• Kyler Thomas Muir
• Noella Mukeshimana

• Ambulatory Surgical Clinic/Center in Greeley, CO
• Providers in Greeley, CO by specialty
• Ambulatory Surgical Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.