Organization Active NPI

Andy M. Fine, M.D., Inc

  • Internal Medicine Physician
  • Littleton, CO
National Provider Identifier
1508103961
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34784 Issued in CO
Legal business name
ANDY M. FINE, M.D., INC
Practice address
20 W Dry Creek Cir
Littleton, CO 80120-4478
Phone
(303) 703-8583
Fax
(303) 703-9791
NPI assigned
Jan 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Olga M Webber
Title
Practice Administrator
Phone
(303) 703-8583

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 34784 CO Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 3227 CO

Addresses

Primary practice location

20 W Dry Creek Cir
Littleton, CO 80120-4478

Mailing address

20 W Dry Creek Cir
Littleton, CO 80120-4478
Phone (303) 703-8583

Other identifiers 1

IdentifierTypeStateIssuer
42951836MedicaidCO

Other names 1

  • Colorado Primary Health Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131122000269 CO Part B Supplier - Clinic/Group Practice 6608925813 Receives reassigned benefits from 3 practitioners
Practice locations: Littleton, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2106222Andy M Fine MD PC20 W Dry Creek Circle, Littleton, CO 80120AccreditationJun 26, 2027

National Provider Directory

National Provider Directory

Locations

7720 S Broadway
Ste G30
Littleton, CO 80122
Phone (303) 703-8583

20 W Dry Creek Cir
Littleton, CO 80120
Phone (303) 346-2443

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1508103961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W DRY CREEK CIR",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801204478",
            "telephone_number": "303-703-8583",
            "fax_number": "303-703-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W DRY CREEK CIR",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801204478",
            "telephone_number": "303-703-8583",
            "fax_number": "303-703-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDY M. FINE, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "WEBBER",
        "authorized_official_first_name": "OLGA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "303-703-8583"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "34784",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3227",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42951836",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado Primary Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.