NPIMap

Individual provider Active NPI

Kevin Michael Clay, M.D.

  • Urology Physician
  • Greeley, CO
National Provider Identifier
1467604637
Registry record updated Mar 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
DR.0052587 Issued in CO
Practice address
5881 W 16TH St
Suite D
Greeley, CO 80634-2910
Phone
(970) 353-1551
Fax
(970) 350-2478
NPI assigned
Oct 18, 2008
Last updated
Mar 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X DR.0052587 CO Primary

Addresses

Primary practice location

5881 W 16TH St
Suite D
Greeley, CO 80634-2910

Mailing address

5881 W 16TH St
Suite D
Greeley, CO 80634-2910
Phone (970) 353-1551

Other identifiers 2

IdentifierTypeStateIssuer
1467604637MedicaidWY
76589340MedicaidCO

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
I20130923000571 CO Practitioner - Urology 1850535386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Ohio State University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

2315 E Harmony Rd
Fort Collins, CO 80528-8620

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Lithotripter LLC Urology CurrentSince Sep 4, 2014 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC Urology CurrentSince Aug 19, 2013 Accepting new patients

Locations

3535 S Lafayette St
Ste 220
Englewood, CO 80113
Phone (303) 839-6060

2315 E Harmony Rd
Ste 140
Fort Collins, CO 80528
Phone (970) 484-6700

5881 W 16th St
Ste D
Greeley, CO 80634
Phone (970) 353-1551

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 2
Greeley, CO 80634
Phone (970) 652-2433

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Interoperability endpoints

  • Direct secure messaging: rockymountainlithotripterllc.kevinclay@133913.advancedmd-direct.com

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1224288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457827200000",
    "number": "1467604637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "address_2": "SUITE D",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-353-1551",
            "fax_number": "970-350-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "address_2": "SUITE D",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-353-1551",
            "fax_number": "970-350-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-18",
        "last_updated": "2016-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CO",
            "license": "DR.0052587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467604637",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76589340",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.