Individual provider Active NPI

Mollie Margaret Mustoe, MD

  • Student in an Organized Health Care Education/Training Program
  • Lakewood, CO
National Provider Identifier
1487395802
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
11600 W 2ND PL
Lakewood, CO 80228-1527
Phone
(720) 321-1708
Fax
(720) 321-0026
NPI assigned
Apr 7, 2022
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CO Primary
Surgery Physician 208600000X TL.0009271 CO

Addresses

Primary practice location

11600 W 2ND PL
Lakewood, CO 80228-1527

Mailing address

935 56TH St Apt 5
Sacramento, CA 95819-3334
Phone (831) 262-0310

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
I20241107004235 CO Order and Referring Only - General SurgeryPractitioner - General Surgery 7113451568

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL.0009271COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Colorado Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmustoe277785@direct.childrenscolorado.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1487395802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 56TH ST APT 5",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193334",
            "telephone_number": "831-262-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281527",
            "telephone_number": "720-321-1708",
            "fax_number": "720-321-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTOE",
        "first_name": "MOLLIE",
        "middle_name": "MARGARET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "TL.0009271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.