NPIMap

Individual provider Active NPI

Charles Gast

  • Otolaryngology Physician
  • Fort Collins, CO
National Provider Identifier
1659814663
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0070200 Issued in CO
Practice address
1120 E Elizabeth St Ste F101
Fort Collins, CO 80524-4044
Phone
(970) 221-1177
NPI assigned
Nov 22, 2016
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0070200 CO Primary

Addresses

Primary practice location

1120 E Elizabeth St Ste F101
Fort Collins, CO 80524-4044

Mailing address

15730 SW Misty CT
Beaverton, OR 97007-4924
Phone (970) 691-7924

Other names 1

  • Charlie Gast Other name

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
I20230831002712 CO Practitioner - Otolaryngology 3779830989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Oregon Health Sciences University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Ear Nose and Throat PCGroup PAC ID 9436127032, 25 clinicians

Practice addresses (Care Compare)

1120 E Elizabeth St
Suite F101
Fort Collins, CO 80524-4044
Phone (970) 221-1177

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0070200COMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Ear, Nose and Throat, PC Otolaryngology CurrentSince Sep 1, 2023 Accepting new patients

Locations

1120 E Elizabeth St
Ste F101
Fort Collins, CO 80524
Phone (970) 221-1177

6500 29th St
Ste 106
Greeley, CO 80634
Phone (970) 330-5555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1659814663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15730 SW MISTY CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970074924",
            "telephone_number": "970-691-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E ELIZABETH ST STE F101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244044",
            "telephone_number": "970-221-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAST",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-22",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "0070200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLIE",
            "last_name": "GAST",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.