Individual provider Active NPI

Michael Graham Loar, MD

  • Family Medicine Physician
  • Highlands Ranch, CO
National Provider Identifier
1508867631
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25456 Issued in CO
Practice address
206 W County Line Rd Ste 210
Highlands Ranch, CO 80129-2320
Phone
(303) 795-5980
Fax
(303) 795-7881
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25456 CO Primary

Addresses

Primary practice location

206 W County Line Rd Ste 210
Highlands Ranch, CO 80129-2320

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4123

Other identifiers 2

IdentifierTypeStateIssuer
080146383OtherCORAILROAD MEDICARE
01254564MedicaidCO

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
I20050518000499 CO Practitioner - Family Practice 3870534068 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25456COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 1, 2017 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 1, 2017 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

206 W County Line Rd
Ste 210
Highlands Ranch, CO 80129
Phone (303) 795-5980

206 W County Line Rd
Ste 300
Highlands Ranch, CO 80129
Phone (303) 795-5980

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

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1508867631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4123",
            "fax_number": "970-624-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W COUNTY LINE RD STE 210",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292320",
            "telephone_number": "303-795-5980",
            "fax_number": "303-795-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOAR",
        "first_name": "MICHAEL",
        "middle_name": "GRAHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "25456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080146383",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01254564",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.