NPIMap

Individual provider Active NPI

Laryssa R Dragan, MD

  • Ophthalmology Physician
  • Fort Collins, CO
National Provider Identifier
1598982902
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
42831 Issued in CO
Practice address
2014 Caribou Dr Ste 150
Fort Collins, CO 80525-4373
Phone
(970) 300-2711
Fax
(415) 329-1031
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 42831 CO Primary

Addresses

Primary practice location

2014 Caribou Dr Ste 150
Fort Collins, CO 80525-4373

Mailing address

1001A E Harmony Rd Ste 425
Fort Collins, CO 80525-3354
Phone (970) 300-2711

Other practice location 1

1300 E 20th St
Cheyenne, WY 82001-4021
Phone (970) 300-2711

Other identifiers 1

IdentifierTypeStateIssuer
27675530MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20050105000316 CO Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 9032167291 Reassigns benefits to 1 organization
I20171018002242 WY Practitioner - Ophthalmology 9032167291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
State University of New York at Stony Brook, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1001 A E Harmony Rd
Fort Collins, CO 80525-3354

1001 A E Harmony Rd Unit
Suite 425
Fort Collins, CO 80525-3354

1300 E 20TH St
Cheyenne, WY 82001-4021
Phone (970) 300-2711

2014 Caribou Dr
Suite 150
Fort Collins, CO 80525-4373
Phone (970) 300-2711

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42831COMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Artisan MD PLLC CurrentSince Nov 16, 2016 Accepting new patients

Locations

2014 Caribou Dr
Ste 150
Fort Collins, CO 80525
Phone (970) 300-2711

1001 E Harmony Rd
Unit A
Fort Collins, CO 80525
Phone (888) 777-2718

1300 E 20th St
Cheyenne, WY 82001
Phone (307) 634-2020

Organizations & group practices 1

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1598982902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001A E HARMONY RD STE 425",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253354",
            "telephone_number": "970-300-2711",
            "fax_number": "970-237-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 CARIBOU DR STE 150",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254373",
            "telephone_number": "970-300-2711",
            "fax_number": "415-329-1031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E 20th St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820014021",
            "country_code": "US",
            "telephone_number": "970-300-2711",
            "fax_number": "970-237-5484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAGAN",
        "first_name": "LARYSSA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "42831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27675530",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.