NPIMap

Individual provider Active NPI

Guy P Van Der Werf, MD

  • Family Medicine Physician
  • Estes Park, CO
National Provider Identifier
1538154257
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31317 Issued in CO
Practice address
131 Stanley Ave Ste 202
Estes Park, CO 80517-6356
Phone
(970) 586-2344
Fax
(970) 586-9060
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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 31317 CO Primary

Addresses

Primary practice location

131 Stanley Ave Ste 202
Estes Park, CO 80517-6356

Mailing address

555 Prospect Ave
Estes Park, CO 80517-6312
Phone (970) 586-2200

Other identifiers 2

IdentifierTypeStateIssuer
1313170MedicaidCO
01313170MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050525001019 CO Practitioner - Family Practice 8426090804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

131 Stanley Ave
Suite 202
Estes Park, CO 80517-6356
Phone (970) 586-2343

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions13
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31317COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Dec 4, 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

555 Prospect Ave
Estes Park, CO 80517
Phone (970) 586-2200

555 Prospect Ave
Ste A
Estes Park, CO 80517
Phone (970) 586-2229

131 Stanley Ave
Ste 202
Estes Park, CO 80517
Phone (970) 586-2343

555 Prospect Ave
Ph
Estes Park, CO 80517
Phone (970) 586-2317

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1538154257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 PROSPECT AVE",
            "city": "ESTES PARK",
            "state": "CO",
            "postal_code": "805176312",
            "telephone_number": "970-586-2200",
            "fax_number": "970-577-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 STANLEY AVE STE 202",
            "city": "ESTES PARK",
            "state": "CO",
            "postal_code": "805176356",
            "telephone_number": "970-586-2344",
            "fax_number": "970-586-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER WERF",
        "first_name": "GUY",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "31317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1313170",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01313170",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Estes Park, CO

Sources for this page

Verify at the official NPI Registry.