NPIMap

Individual provider Active NPI

Michael Christopher Fraterelli, MD

  • Surgery Physician
  • Aurora, CO
National Provider Identifier
1407852619
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
40410 Issued in CO
Practice address
1421 S Potomac St Ste 220
Aurora, CO 80012
Phone
(303) 337-5600
Fax
(303) 337-7734
NPI assigned
Jun 22, 2005
Last updated
Mar 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 40410 CO Primary

Addresses

Primary practice location

1421 S Potomac St Ste 220
Aurora, CO 80012

Mailing address

1421 S Potomac St Ste 220
Aurora, CO 80012-4512
Phone (303) 337-5600

Other identifiers 2

IdentifierTypeStateIssuer
19058551MedicaidCO
523758OtherCOMEDICARE ID - TYPE UNSPECIFIED

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
I20040413000131 CO Practitioner - General Surgery 7719971779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Surgical and Critical Care Associates PLLCGroup PAC ID 7810978095, 22 clinicians

Practice addresses (Care Compare)

1421 S Potomac St
Suite 220
Aurora, CO 80012-4512
Phone (303) 337-5600

1501 S Potomac St
Aurora, CO 80012-5411
Phone (303) 695-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)15
Hernia repair (minimally invasive)1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Surgical and Critical Care Associates PLLC Surgery CurrentSince Feb 3, 2004 Accepting new patients
HCA Healthone LLC Past Accepting new patients
Joseph J Major DO PC Surgery Past Accepting new patients

Locations

1501 S Potomac St
Denver, CO 80012
Phone (303) 695-2604

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

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1407852619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 S POTOMAC ST STE 220",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124512",
            "telephone_number": "303-337-5600",
            "fax_number": "303-337-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 S POTOMAC ST STE 220",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80012",
            "telephone_number": "303-337-5600",
            "fax_number": "303-337-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRATERELLI",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "40410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19058551",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "523758",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.