Active NPI
Paul R. Bacalis
- Nurse Practitioner
- Fort Collins, CO
National Provider Identifier
1528334166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- C-APN.0000174-C-NP
- Practice address
- 1024 S Lemay Ave
Fort Collins, CO 80524-3929 - Phone
- (970) 495-7000
- Fax
- (303) 306-7753
- NPI assigned
- Mar 28, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | C-APN.0000174-C-NP | CO | Primary |
Addresses
Primary practice location
1024 S Lemay Ave
Fort Collins, CO 80524-3929
Mailing address
PO Box 912215
Denver, CO 80291-2215
Phone (303) 306-7783
Other names 1
- Paul R. Bacalis
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150203001908 | CO | Practitioner - Nurse Practitioner | 1658536016 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.04 of 100
- Quality
- 87.35
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physicians of the Rockies, PC | Current | Accepting new patients | |
| Emergency Physicians of the Rockies, PC | Current | Accepting new patients |
Locations
1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000
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.
-
- Emergency Medicine Physician
- Ft Collins, CO
- NPI 1174570717
CO
-
- Emergency Medicine Physician
- Longmont, CO
- NPI 1285133819
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459728000000",
"number": "1528334166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 912215",
"city": "DENVER",
"state": "CO",
"postal_code": "802912215",
"telephone_number": "303-306-7783",
"fax_number": "303-306-7753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1024 S LEMAY AVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805243929",
"telephone_number": "970-495-7000",
"fax_number": "303-306-7753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACALIS",
"first_name": "PAUL",
"middle_name": "R.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-28",
"last_updated": "2016-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "C-APN.0000174-C-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PAUL",
"last_name": "BACALIS",
"middle_name": "R.",
"credential": "APN-NP",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.