Individual provider Active NPI

Bryce Mikel, M.D.

  • Pulmonary Disease Physician
  • Fort Collins, CO
National Provider Identifier
1487037909
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
DR.0069246 Issued in CO
Practice address
2121 E Harmony Rd Unit 300
Fort Collins, CO 80528-3403
Phone
(970) 221-9104
NPI assigned
Jul 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 61142 MN
Pulmonary Disease Physician 207RP1001X DR.0069246 CO Primary

Addresses

Primary practice location

2121 E Harmony Rd Unit 300
Fort Collins, CO 80528-3403

Mailing address

PO Box 732031
Dallas, TX 75373-2031
Phone (866) 429-6045

Other practice location 1

8100 W 78th St
Edina, MN 55439
Phone (952) 914-8100

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
I20221004002486 CO Practitioner - Pulmonary Disease 3870885692 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61142MNMDInternal Medicine Physician
DR.0069246COMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Pulmonary Disease CurrentSince Sep 12, 2022 Accepting new patients
Poudre Valley Medical Group, LLC Pulmonary Disease CurrentSince Sep 12, 2022 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2121 E Harmony Rd
Unit 300
Fort Collins, CO 80528
Phone (970) 224-0429

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

Interoperability endpoints

  • Direct secure messaging: bmikel257290@direct.llu.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1487037909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732031",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753732031",
            "telephone_number": "866-429-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283403",
            "telephone_number": "970-221-9104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 W 78th St",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "55439",
            "country_code": "US",
            "telephone_number": "952-914-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKEL",
        "first_name": "BRYCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "61142",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CO",
            "license": "DR.0069246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.