NPIMap

Individual provider Active NPI

Emily Niloufar Ahadizadeh, MD

  • Otolaryngology Physician
  • Fort Collins, CO
National Provider Identifier
1346745965
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
DR.0070911 Issued in CO
Practice address
2001 S Shields St Ste 101
Fort Collins, CO 80526-1827
Phone
(970) 493-5334
NPI assigned
Mar 26, 2018
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X DR.0070911 CO Primary

Addresses

Primary practice location

2001 S Shields St Ste 101
Fort Collins, CO 80526-1827

Mailing address

2001 S Shields St Ste 101
Fort Collins, CO 80526-1827

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
I20231024000466 CO Practitioner - Otolaryngology 6103176961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2001 S Shields St
Fort Collins, CO 80526-1827
Phone (970) 493-5334

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 25, 2023 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 25, 2023 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2001 S Shields St
Ste 101
Fort Collins, CO 80526
Phone (970) 297-6600

2001 S Shields St
Ste E101
Fort Collins, CO 80526
Phone (970) 493-5334

4601 S Mason St
Fort Collins, CO 80525
Phone (970) 266-3600

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1346745965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S SHIELDS ST STE 101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S SHIELDS ST STE 101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261827",
            "telephone_number": "970-493-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHADIZADEH",
        "first_name": "EMILY",
        "middle_name": "NILOUFAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "DR.0070911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.