NPIMap

Individual provider Active NPI

Michael Lipnick, M.D.

  • Family Medicine Physician
  • Julesburg, CO
National Provider Identifier
1407863871
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41949 Issued in CO
Practice address
116 E 9TH St
Julesburg, CO 80737-1100
Phone
(970) 474-3376
Fax
(970) 474-2461
NPI assigned
Aug 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 41949 CO Primary

Addresses

Primary practice location

116 E 9TH St
Julesburg, CO 80737-1100

Mailing address

900 Cedar St
Julesburg, CO 80737-1121
Phone (970) 474-3376

Other identifiers 1

IdentifierTypeStateIssuer
39106241MedicaidCO

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
I20050805000796 CO Practitioner - General PracticePractitioner - Family Practice 3173552502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ponderosa Family Physicians PCGroup PAC ID 1658261854, 8 clinicians

Practice addresses (Care Compare)

14991 E Hampden Ave
Suite 210
Aurora, CO 80014-3985
Phone (303) 690-4891

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41949COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ponderosa Family Physicians PC Family Medicine CurrentSince Sep 22, 2010 Accepting new patients
Highlands Ranch Healthcare LLC Past Accepting new patients

Locations

14991 E Hampden Ave
Ste 210
Aurora, CO 80014
Phone (303) 690-4891

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 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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407863871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CEDAR ST",
            "city": "JULESBURG",
            "state": "CO",
            "postal_code": "807371121",
            "telephone_number": "970-474-3376",
            "fax_number": "970-474-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E 9TH ST",
            "city": "JULESBURG",
            "state": "CO",
            "postal_code": "807371100",
            "telephone_number": "970-474-3376",
            "fax_number": "970-474-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPNICK",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "41949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39106241",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Julesburg, CO

Sources for this page

Verify at the official NPI Registry.