Individual provider Active NPI

Jonathan Bradley Stern, M.D.

  • Obstetrics & Gynecology Physician
  • Fort Collins, CO
National Provider Identifier
1437158565
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
47549 Issued in CO
Practice address
1107 South Lemay Avenue
Suite 300
Fort Collins, CO 80524-3957
Phone
(970) 493-7442
Fax
(970) 493-2990
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 30753 TN
Obstetrics & Gynecology Physician 207V00000X 47549 CO Primary

Addresses

Primary practice location

1107 South Lemay Avenue
Suite 300
Fort Collins, CO 80524-3957

Mailing address

1107 South Lemay Avenue
Suite 300
Fort Collins, CO 80524-3957
Phone (970) 493-7442

Other practice location 1

1024 S LeMay Ave
Fort Collins, CO 80524-3929
Phone (970) 495-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20090820000637 CO Practitioner - Obstetrics/Gynecology 6204980576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Tennessee, HSC, College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Health Care IncGroup PAC ID 7618880709, 56 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929
Phone (970) 495-7127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47549COMDObstetrics & Gynecology Physician
30753TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care, Inc CurrentSince Aug 12, 2010 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Aug 12, 2010 Accepting new patients
Fort Collins Women'S Clinic, P.C. CurrentSince Jul 15, 2009 Accepting new patients
Poudre Valley Health Care Inc. Current Accepting new patients
Fort Collins Women'S Clinic, PC Obstetrics & Gynecology CurrentSince Jul 15, 2009 Accepting new patients
Poudre Valley Medical Group, LLC Obstetrics & Gynecology Past Accepting new patients

Locations

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1107 S Lemay Ave
Ste 300
Fort Collins, CO 80524
Phone (970) 493-7442

1025 Pennock Pl
Ste 114
Fort Collins, CO 80524
Phone (970) 495-8800

2500 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 493-7442

Interoperability endpoints

  • Direct secure messaging: bradley.sternmd.p1@direct.thewomensclinic.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1437158565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 SOUTH LEMAY AVENUE",
            "address_2": "SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243957",
            "telephone_number": "970-493-7442",
            "fax_number": "970-493-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 SOUTH LEMAY AVENUE",
            "address_2": "SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243957",
            "telephone_number": "970-493-7442",
            "fax_number": "970-493-2990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1024 S LeMay Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805243929",
            "country_code": "US",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STERN",
        "first_name": "JONATHAN",
        "middle_name": "BRADLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "30753",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "47549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.