NPIMap

Individual provider Active NPI

Stephen Groendyk, DO

  • Internal Medicine Physician
  • Pueblo, CO
National Provider Identifier
1659868479
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
TL.0007292 Issued in CO
Practice address
400 W 16TH St
Pueblo, CO 81003-2745
Phone
(171) 958-4400
NPI assigned
Apr 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TL.0007292 CO Primary

Addresses

Primary practice location

400 W 16TH St
Pueblo, CO 81003-2745

Mailing address

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4000

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
I20210908002220 CO Practitioner - Internal Medicine 5395082200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Colorado Hospitalists Professional LLCGroup PAC ID 8325147507, 85 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Poudre Valley Hospital
Fort Collins, CO 80524-3929
Phone (970) 495-7142

2500 Rocky Mountain Ave
Loveland, CO 80538-9004
Phone (970) 624-2500

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 495-7153

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.23 of 100Reported as group
Quality
87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL.0007292COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Colorado Hospitalists Professional LLC CurrentSince Jul 1, 2021 Accepting new patients
Pathways Hospice Internal Medicine Current Accepting new patients
Pathways Hospice Internal Medicine CurrentSince Aug 23, 2023 Accepting new patients
Pathways Hospice CurrentSince Aug 23, 2023 Accepting new patients
Medical Center of the Rockies Past Accepting new patients

Locations

8289 E Lowry Blvd
Denver, CO 80230
Phone (303) 321-2828

317 Carpenter Rd
Fort Collins, CO 80525
Phone (970) 663-3500

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

2637 Midpoint Dr
Ste B
Fort Collins, CO 80525
Phone (970) 488-1640

305 Carpenter Rd
Fort Collins, CO 80525
Phone (970) 663-3500

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

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

Organizations & group practices 5

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": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1659868479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032745",
            "telephone_number": "719-584-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032745",
            "telephone_number": "171-958-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROENDYK",
        "first_name": "STEPHEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "TL.0007292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.