NPIMap

Individual provider Active NPI

Mandip KC, MD

  • Gastroenterology Physician
  • Castle Rock, CO
National Provider Identifier
1487099685
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
DR.0068727 Issued in CO
Practice address
3911 Ambrosia St Ste 201
Castle Rock, CO 80109-3888
Phone
(303) 788-8888
Fax
(844) 347-5158
NPI assigned
May 2, 2013
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 60475 MN
Gastroenterology Physician 207RG0100X DR.0068727 CO Primary

Addresses

Primary practice location

3911 Ambrosia St Ste 201
Castle Rock, CO 80109-3888

Mailing address

3911 Ambrosia St Ste 201
Castle Rock, CO 80109-3888
Phone (303) 788-8888

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
I20220813000732 CO Practitioner - Gastroenterology 8628373628 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Colorado School of Medicine, Denver, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3911 Ambrosia St
Suite 201
Castle Rock, CO 80109-3888
Phone (303) 788-8888

602 N 6TH St W
Cheyenne Wells, CO 80810-5125
Phone (719) 767-5661

615 W 5TH St N
Cheyenne Wells, CO 80810
Phone (719) 767-5669

PO Box
Suite 578
Cheyenne Wells, CO 80810

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy50
Upper gastrointestinal (GI) endoscopy for acid reflux38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0068727COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Denver Gastroenterology, PC Gastroenterology CurrentSince Sep 19, 2022 Accepting new patients
Keefe Memorial Health Service District Multi-Specialty CurrentSince Jul 1, 2025 Accepting new patients
South Denver Gastroenterology, PC Multi-Specialty Current Accepting new patients
Keefe Memorial Health Service District CurrentSince Jul 1, 2025 Accepting new patients
South Denver Gastroenterology, PC Multi-Specialty CurrentSince Sep 19, 2022 Accepting new patients

Locations

3911 Ambrosia St
Ste 201
Castle Rock, CO 80109
Phone (303) 788-8888

602 N 6th St W
Cheyenne Wls, CO 80810
Phone (719) 767-5661

10 Inverness Dr E
Ste 220
Englewood, CO 80112

499 E Hampden Ave
Ste 420
Englewood, CO 80113
Phone (303) 788-8888

102 E 2nd Ave
Kit Carson, CO 80825
Phone (719) 962-3501

10103 Ridgegate Pkwy
Ste 312A
Lone Tree, CO 80124
Phone (303) 788-8888

9397 Crown Crest Blvd
Ste 221
Parker, CO 80138
Phone (303) 788-8888

Interoperability endpoints

  • Direct secure messaging: mandip.kc.1@3461.direct.athenahealth.com

Organizations & group practices 5

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 9

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": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1487099685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 AMBROSIA ST STE 201",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093888",
            "telephone_number": "303-788-8888",
            "fax_number": "844-347-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 AMBROSIA ST STE 201",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093888",
            "telephone_number": "303-788-8888",
            "fax_number": "844-347-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KC",
        "first_name": "MANDIP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "60475",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "DR.0068727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.