Individual provider Active NPI

Heather Bidgoli Vance, M.D.

  • Family Medicine Physician
  • Louisville, CO
National Provider Identifier
1336451319
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
52066 Issued in CO
Practice address
80 Health Park Dr
Suite 100
Louisville, CO 80027-9584
Phone
(303) 666-2722
Fax
(303) 673-0438
NPI assigned
Jul 8, 2010
Last updated
Oct 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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 52066 CO Primary

Addresses

Primary practice location

80 Health Park Dr
Suite 100
Louisville, CO 80027-9584

Mailing address

2750 Broadway St
Attn Marty Trahan
Boulder, CO 80304-3573
Phone (303) 440-3122

Other names 1

  • Heather Bidgoli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200204000377 MI Practitioner - Family Practice 2961636014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Healthcare CadillacGroup PAC ID 6305161514, shared by 5 NPIs, 104 clinicians

Practice addresses (Care Compare)

207 Fletcher St
RM 245G
Ann Arbor, MI 48109-1050
Phone (734) 763-9631

7985 S Mackinaw TRL
Cadillac, MI 49601-8111
Phone (231) 876-6200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52066COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan-Uhs-University Health Ser CurrentSince Dec 21, 2019 Accepting new patients

Locations

207 Fletcher St
Ann Arbor, MI 48109
Phone (734) 764-8320

207 Fletcher St
Rm 0
Ann Arbor, MI 48109

207 Fletcher St
Rm 245G
Ann Arbor, MI 48109
Phone (734) 763-9631

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1336451319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "address_2": "ATTN MARTY TRAHAN",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-440-3122",
            "fax_number": "303-440-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HEALTH PARK DR",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279584",
            "telephone_number": "303-666-2722",
            "fax_number": "303-673-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "HEATHER",
        "middle_name": "BIDGOLI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "52066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "BIDGOLI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, CO

Sources for this page

Verify at the official NPI Registry.