NPIMap

Individual provider Active NPI

Mark McClure Paulsen, M.D.

  • Family Medicine Physician
  • Kremmling, CO
National Provider Identifier
1700835857
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29741 Issued in CO
Practice address
214 South 4TH Street
Kremmling, CO 80459-0399
Phone
(970) 724-3442
Fax
(970) 724-9606
NPI assigned
May 8, 2006
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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 29741 CO Primary

Addresses

Primary practice location

214 South 4TH Street
Kremmling, CO 80459-0399

Mailing address

P.O. Box 399
214 S. 4TH Street
Kremmling, CO 80459-0399
Phone (970) 724-3442

Other identifiers 1

IdentifierTypeStateIssuer
01297415MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpaulsen23102@directe.centura.org Health Information Exchange (HIE)

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
I20080626000427 CO Practitioner - Family Practice 9436177342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Granby Park Dr S
Granby, CO 80446-5304
Phone (970) 724-3442

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.61 of 100Reported as group
Quality
76.83
Promoting interoperability
100
Improvement activities
40
Cost
35.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29741COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kremmling Memorial Hospital District CurrentSince Jan 7, 2008 Accepting new patients
Kremmling Memorial Hospital District CurrentSince Jan 7, 2008 Accepting new patients

Locations

1000 Granby Park Dr S
Granby, CO 80446
Phone (970) 668-5771

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

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1700835857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 399",
            "address_2": "214 S. 4TH STREET",
            "city": "KREMMLING",
            "state": "CO",
            "postal_code": "804590399",
            "telephone_number": "970-724-3442",
            "fax_number": "970-724-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 SOUTH 4TH STREET",
            "city": "KREMMLING",
            "state": "CO",
            "postal_code": "804590399",
            "telephone_number": "970-724-3442",
            "fax_number": "970-724-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSEN",
        "first_name": "MARK",
        "middle_name": "MCCLURE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "29741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01297415",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpaulsen23102@directe.centura.org",
            "affiliation": "N",
            "endpointDescription": "MPAULSEN MIDDLE PARK HEALTH DIRECT EMAIL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "214 South 4th Street",
            "city": "Kremmling",
            "state": "CO",
            "country_code": "US",
            "postal_code": "804590399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kremmling, CO

Sources for this page

Verify at the official NPI Registry.