NPIMap

Individual provider Active NPI

Sean Michael Serell, M.D.

  • Anesthesiology Physician
  • Fort Collins, CO
National Provider Identifier
1629066253
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DR.0043360 Issued in CO
Practice address
1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone
(970) 224-2985
Fax
(970) 472-9381
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 00048821 WA
Anesthesiology Physician 207L00000X DR.0043360 CO Primary

Addresses

Primary practice location

1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000

Mailing address

1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone (970) 224-2985

Other identifiers 2

IdentifierTypeStateIssuer
67987222MedicaidCO
121499300MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NE2 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
I20050802001098 CO Practitioner - Anesthesiology 4688602485 Reassigns benefits to 1 organization
I20260618000471 NE Practitioner - Anesthesiology 4688602485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Northern Colorado Anesthesia Professionals PLLCGroup PAC ID 6800878760, 155 clinicians
Northstar Anesthesia of Nebraska LLCGroup PAC ID 2264857135, 21 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Ncap PLLC
Fort Collins, CO 80524-3929
Phone (970) 495-7000

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

4021 Ave B
Scottsbluff, NE 69361-4602
Phone (214) 687-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00048821WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Colorado Anesthesia Professionals PLLC Anesthesiology CurrentSince Jul 11, 2005 Accepting new patients

Locations

1236 E Elizabeth St
Ste 1
Fort Collins, CO 80524
Phone (970) 484-6256

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

2500 E Prospect Rd
Fort Collins, CO 80525
Phone (800) 722-7441

3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 922-3622

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1629066253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985",
            "fax_number": "970-472-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985",
            "fax_number": "970-472-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERELL",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "00048821",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR.0043360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67987222",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121499300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.