Individual provider Active NPI

Jose Luis Vasquez, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Highlands Ranch, CO
National Provider Identifier
1649278318
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN0002658 Issued in CO
Practice address
7871 S. Quebec Street
Suite 200
Highlands Ranch, CO 80130-5861
Phone
(303) 683-5620
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN0002658 CO Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 109020 CO

Addresses

Primary practice location

7871 S. Quebec Street
Suite 200
Highlands Ranch, CO 80130-5861

Mailing address

928 12TH Street
Greeley, CO 80631-4024
Phone (970) 352-1056

Other identifiers 1

IdentifierTypeStateIssuer
91002761MedicaidCO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201208000227 CO Practitioner - Nurse Practitioner 6709821945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1136 E Stuart St
Suite 4202
Fort Collins, CO 80525-1193
Phone (970) 909-2035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109020COMDPsychiatric/Mental Health Nurse Practitioner
APN0002658COMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Noco New Beginnings CurrentSince Nov 10, 2020 Accepting new patients
Health Stop LLC Past Accepting new patients

Locations

1136 E Stuart St
Ste 4202
Fort Collins, CO 80525
Phone (970) 221-5925

1122 9th St
Ste 204
Greeley, CO 80631
Phone (970) 909-2035

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1649278318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 12TH STREET",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806314024",
            "telephone_number": "970-352-1056",
            "fax_number": "970-336-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7871 S. QUEBEC STREET",
            "address_2": "SUITE 200",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801305861",
            "telephone_number": "303-683-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN0002658",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "109020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91002761",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.