Individual provider Active NPI

Sandra Lopina Deveny, M.D.

  • Family Medicine Physician
  • Glenwood Springs, CO
National Provider Identifier
1477545374
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46945 Issued in CO
Practice address
1905 Blake Ave
Suite 101
Glenwood Springs, CO 81601-4288
Phone
(970) 945-2840
Fax
(970) 945-2893
NPI assigned
Aug 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 46945 CO
Emergency Medicine Physician 207P00000X 35055564 OH
Family Medicine Physician 207Q00000X 46945 CO Primary

Addresses

Primary practice location

1905 Blake Ave
Suite 101
Glenwood Springs, CO 81601-4288

Mailing address

1905 Blake Ave Ste 101
Glenwood Springs, CO 81601-4206
Phone (970) 945-2840

Other identifiers 1

IdentifierTypeStateIssuer
96107855MedicaidCO

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
I20090216000506 CO Practitioner - Emergency Medicine 1850284357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Toledo College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Family Health CentersGroup PAC ID 3173413101, 20 clinicians

Practice addresses (Care Compare)

123 Emma Rd
Suite 106
Basalt, CO 81621-9169
Phone (970) 945-2840

195 W
Rifle, CO 81650-4716
Phone (970) 945-2840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35055564OHMDEmergency Medicine Physician
46945COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Family Health Centers CurrentSince Oct 15, 2008 Accepting new patients
Mountain Family Health Centers Current Accepting new patients
Mountain Family Health Centers CurrentSince Oct 15, 2008 Accepting new patients
Internal Medicine Specialists, Inc Past Accepting new patients
Bes of Ohio, LLC Emergency Medicine Past Accepting new patients
Bes of Ohio, LLC, Dba Medgroup Past Accepting new patients
Mountain Family Health Centers Past Accepting new patients

Locations

230 Chapel Sq
#D102
Avon, CO 81620

123 Emma Rd
Basalt, CO 81621

123 Emma Rd
Ste 106
Basalt, CO 81621

1905 Blake Ave
Ste 101
Glenwood Springs, CO 81601

195 W 14th St
Ste C
Rifle, CO 81650

Interoperability endpoints

  • Direct secure messaging: sandra.deveny.p1@direct.mfhc.nextgenshare.com
  • FHIR API: https://api.platform.athenahealth.com/16545/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1477545374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 BLAKE AVE STE 101",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014206",
            "telephone_number": "970-945-2840",
            "fax_number": "970-945-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 BLAKE AVE",
            "address_2": "SUITE 101",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014288",
            "telephone_number": "970-945-2840",
            "fax_number": "970-945-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVENY",
        "first_name": "SANDRA",
        "middle_name": "LOPINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "46945",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35055564",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "46945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96107855",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Springs, CO

Sources for this page

Verify at the official NPI Registry.