Individual provider Active NPI

Aaron Soots Fraser, D.O.

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1629114335
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0050395 Issued in CO
Practice address
1615 Silversmith Rd
Colorado Springs, CO 80921-7225
Phone
(719) 633-5255
Fax
(719) 488-6753
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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 0050395 CO Primary

Addresses

Primary practice location

1615 Silversmith Rd
Colorado Springs, CO 80921-7225

Mailing address

1615 Silversmith Rd
Colorado Springs, CO 80921-7225
Phone (719) 633-5255

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
I20140616001353 CO Practitioner - Family Practice 2062592371 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0050395COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Professional Medical Group LLC Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Fraser Professional Medical Group Family Medicine Past Accepting new patients
Fraser Professional Medical Group LLC Past Accepting new patients
Fraser Professional Medical Group LLC Family Medicine Past Accepting new patients

Locations

1615 Silversmith Rd
Colorado Springs, CO 80921
Phone (719) 323-5772

Organizations & group practices 4

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1629114335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 SILVERSMITH RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809217225",
            "telephone_number": "719-633-5255",
            "fax_number": "719-488-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 SILVERSMITH RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809217225",
            "telephone_number": "719-633-5255",
            "fax_number": "719-488-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "AARON",
        "middle_name": "SOOTS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "0050395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.