NPIMap

Individual provider Active NPI

Daniel Stepan, PA-C

  • Medical Physician Assistant
  • Durango, CO
National Provider Identifier
1669939823
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-5705 Issued in CO
Practice address
575 Rivergate
Durango, CO 81301-7487
Phone
(970) 247-3537
NPI assigned
Feb 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA-5705 CO Primary

Addresses

Primary practice location

575 Rivergate
Durango, CO 81301-7487

Mailing address

575 Rivergate
Durango, CO 81301-7487
Phone (970) 247-3537

Other practice location 1

2030 Mountain View Ave Ste 540
Longmont, CO 80501-3183
Phone (303) 651-5302

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
I20190411002494 CO Practitioner - Physician Assistant 2961743331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Animas Surgical Hospital LLCGroup PAC ID 0143295428, 61 clinicians

Practice addresses (Care Compare)

575 Rivergate
Unit 204
Durango, CO 81301-7490
Phone (970) 403-1340

575 Rivergate LN
Durango, CO 81301-7487
Phone (970) 247-3537

575 Rivergate LN
Unit 105
Durango, CO 81301-7490
Phone (970) 259-3020

Hospital & facility affiliations

  • Animas Surgical Hospital, LLC Hospital, Durango, CO, CCN 060117
  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013
  • Southwest Memorial Hospital Hospital, Cortez, CO, CCN 061327
  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-5705COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Animas Surgical Hospital, LLC Single Specialty CurrentSince Dec 11, 2020 Accepting new patients
Durango Surgery Center LLC Single Specialty CurrentSince Dec 11, 2020 Accepting new patients
Animas Surgical Hospital, LLC Single Specialty Past Accepting new patients

Locations

1266 Escalante Dr
Ste 101
Durango, CO 81303
Phone (248) 396-8109

575 Rivergate Ln
Unit 204
Durango, CO 81301
Phone (970) 382-8292

575 Rivergate Ln
Durango, CO 81301
Phone (719) 648-5678

6330 S Western Ave
Ste 150
Sioux Falls, SD 57108

6128 S Lyncrest Ave
Sioux Falls, SD 57108
Phone (605) 334-1363

Organizations & group practices 3

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1669939823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017487",
            "telephone_number": "970-247-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017487",
            "telephone_number": "970-247-3537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Mountain View Ave Ste 540",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805013183",
            "country_code": "US",
            "telephone_number": "303-651-5302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPAN",
        "first_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-25",
        "last_updated": "2021-03-11",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA-5705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.