Individual provider Active NPI

Keith A Rangel, M.D.

  • Family Medicine Physician
  • Windsor, CO
National Provider Identifier
1710031018
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26697 Issued in CO
Practice address
1455 Main St
Suite 100
Windsor, CO 80550-5559
Phone
(970) 686-3950
Fax
(970) 686-3960
NPI assigned
Jan 23, 2007
Last updated
Jan 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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 26697 CO Primary

Addresses

Primary practice location

1455 Main St
Suite 100
Windsor, CO 80550-5559

Mailing address

1455 Main St
Suite 100
Windsor, CO 80550-5559
Phone (970) 686-3950

Other identifiers 2

IdentifierTypeStateIssuer
1266972MedicaidCO
P00944653OtherCOMEDICARE RAILROAD CARRIER PTAN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060412000752 CO Practitioner - Family PracticePractitioner - Pathology 0547279952 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26697COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 13, 2010 Accepting new patients

Locations

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1455 Main St
Ste 100
Windsor, CO 80550
Phone (970) 207-4857

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1710031018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 MAIN ST",
            "address_2": "SUITE 100",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505559",
            "telephone_number": "970-686-3950",
            "fax_number": "970-686-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 MAIN ST",
            "address_2": "SUITE 100",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505559",
            "telephone_number": "970-686-3950",
            "fax_number": "970-686-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGEL",
        "first_name": "KEITH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "26697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1266972",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944653",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CO

Sources for this page

Verify at the official NPI Registry.