NPIMap

Individual provider Active NPI

Michael Andrew Crocker, MD

  • Anesthesiology Physician
  • Colorado Springs, CO
National Provider Identifier
1720052269
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
40093 Issued in CO
Practice address
1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533
Phone
(719) 365-6999
Fax
(719) 365-2837
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 40093 CO Primary

Addresses

Primary practice location

1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4034

Other practice location 1

9395 Crown Crest Blvd
Parker, CO 80138-8573
Phone (303) 603-3520

Other practice location 2

9395 Crown Crest Blvd
Parker, CO 80138
Phone (303) 603-3520

Other practice location 3

9395 Crown Crest Blvd
Parker, CO 80138
Phone (303) 603-3520

Other identifiers 1

IdentifierTypeStateIssuer
71972765MedicaidCO

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
I20040419000228 CO Practitioner - Anesthesiology 2567457674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arkansas College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder St
Suite 2508
Colorado Springs, CO 80909-5533
Phone (719) 365-6999

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Uchealth Grandview Hospital Hospital, Colorado Springs, CO, CCN 060130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40093COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Anesthesiology CurrentSince Jan 29, 2018 Accepting new patients
Guardian Anesthesia Services, Inc Anesthesiology CurrentSince Mar 15, 2015 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 29, 2018 Accepting new patients
Anesthesia Associates of Kansas City PA Anesthesiology Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1400 E Boulder St
Ste 1183
Colorado Springs, CO 80909
Phone (719) 365-6999

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1400 E Boulder St
Ste 2508
Colorado Springs, CO 80909
Phone (719) 365-1292

2525 S Downing St
Denver, CO 80210
Phone (303) 744-2706

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

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

9395 Crown Crest Blvd
Parker, CO 80138
Phone (303) 269-4000

Organizations & group practices 4

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1720052269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4034",
            "fax_number": "970-490-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 2508",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-6999",
            "fax_number": "719-365-2837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9395 Crown Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801388573",
            "country_code": "US",
            "telephone_number": "303-603-3520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9395 Crown Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "80138",
            "country_code": "US",
            "telephone_number": "303-603-3520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9395 Crown Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "80138",
            "country_code": "US",
            "telephone_number": "303-603-3520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "40093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71972765",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.