NPIMap

Individual provider Active NPI

Nicholas Leland Hugentobler, DPM

  • Foot & Ankle Surgery Podiatrist
  • Durango, CO
National Provider Identifier
1508096116
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
716 Issued in CO
Practice address
270 E 8TH Ave
Suite N102
Durango, CO 81301-5708
Phone
(970) 903-9853
Fax
(970) 616-6745
NPI assigned
Jul 16, 2009
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD.344 NM
Foot & Ankle Surgery Podiatrist 213ES0103X 716 CO Primary

Addresses

Primary practice location

270 E 8TH Ave
Suite N102
Durango, CO 81301-5708

Mailing address

6405 S 3000 E Ste 201
Salt Lake City, UT 84121-6990
Phone (801) 266-3113

Other practice location 1

2095 N Dolores Road
Cortez, CO 81321-8924
Phone (970) 564-8086

Other practice location 2

4740 N Butler Ave
Farmington, NM 87401-0826
Phone (505) 324-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NM, UT3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120813000617 CO Practitioner - Podiatry 1658527361 Reassigns benefits to 1 organization
I20150506000161 NM Practitioner - Podiatry 1658527361 Reassigns benefits to 1 organization
I20170110001580 UT Practitioner - Podiatry 1658527361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Taylor G Wright PCGroup PAC ID 8426362450, 28 clinicians

Practice addresses (Care Compare)

270 E 8TH Ave
Suite N102
Durango, CO 81301-5708
Phone (970) 903-9853

4740 N Butler Ave
Farmington, NM 87401-0826
Phone (505) 324-6300

4760 N Butler Ave
Farmington, NM 87401-0816
Phone (505) 324-6300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue181
Removal of nail tissue319
Removal or shaving of skin growth91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD.344NMMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan County Hospital Current Accepting new patients
Precision Medical Labs, LLC Current Accepting new patients
Innovation Medical Group PC Foot & Ankle Surgery CurrentSince Nov 17, 2021 Accepting new patients
San Juan County Hospital CurrentSince May 1, 2017 Accepting new patients
San Juan County Hospital CurrentSince May 1, 2017 Accepting new patients
Taylor G Wright PC Foot & Ankle Surgery PastSince Feb 1, 2023 Accepting new patients
Taylor G Wright PC Foot & Ankle Surgery PastSince Jul 23, 2023 Accepting new patients

Locations

2095 N Dolores Rd
Cortez, CO 81321
Phone (970) 564-8086

270 E 8th Ave
Ste N102
Durango, CO 81301
Phone (970) 560-1773

4760 N Butler Ave
Ste B2
Farmington, NM 87401
Phone (505) 324-6300

4740 N Butler Ave
Farmington, NM 87401
Phone (505) 324-6300

836 S Angel St
Ste 102
Layton, UT 84041
Phone (435) 291-1375

6405 S 3000 E
Ste 201
Salt Lake City, UT 84121

6405 S 3000 E
Ste 300
Salt Lake Cty, UT 84121
Phone (801) 266-5113

4624 S Holladay Blvd
Ste 201
Slc, UT 84117
Phone (385) 234-4785

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d2bc3d5a-3c39-4553-86b1-b3aa0a5429a7/

Organizations & group practices 8

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 11

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": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1508096116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 S 3000 E STE 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216990",
            "telephone_number": "801-266-3113",
            "fax_number": "801-266-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E 8TH AVE",
            "address_2": "SUITE N102",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015708",
            "telephone_number": "970-903-9853",
            "fax_number": "970-616-6745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2095 N Dolores Road",
            "address_purpose": "LOCATION",
            "city": "Cortez",
            "state": "CO",
            "postal_code": "813218924",
            "country_code": "US",
            "telephone_number": "970-564-8086",
            "fax_number": "970-564-8087",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4740 N Butler Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874010826",
            "country_code": "US",
            "telephone_number": "505-324-6300",
            "fax_number": "505-327-2218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUGENTOBLER",
        "first_name": "NICHOLAS",
        "middle_name": "LELAND",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NM",
            "license": "POD.344",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.