Cody Michael-Ty Deck, DO
Individual provider Active NPI Family Medicine Physician · Greeley, CO
NPI 1720669591 · NPPES record last updated Sep 6, 2024
Key facts
- NPI
- 1720669591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- DR.0072886 (CO)
- Practice address
- 1801 16TH St
Greeley, CO 80631-5199 - Phone
- (970) 810-6087
- NPI assigned
- Apr 14, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Lake Erie College of Osteopathic Medicine, Erie, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Hospital Based Physicians Colorado LLC
East Morgan County Hospital
Practice addresses (Care Compare)
1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4593
2400 Edison St
Suite 101 Banner Family Medicine Brush
Brush, CO 80723-1640
Phone (970) 842-6262
909 E Railroad Ave
Suite 101 Banner Health Clinic Fort Morgan
Fort Morgan, CO 80701-3301
Phone (970) 542-4700
Hospital & facility affiliations
- Banner North Colorado Medical Center
- East Morgan County Hospital
- Banner North Co Medical Center - Loveland Campus
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240927001669 | CO | Practitioner - Family Practice |
7719418078 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0072886 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Morgan County Hospital | Current |
Accepting new patients | |
| East Morgan County Hospital | Current |
Accepting new patients | |
| Banner Hospital Based Physicians Colorado LLC | Current | Accepting new patients | |
| Banner Hospital Based Physicians Colorado LLC | Current |
Accepting new patients | |
| Banner Hospital Based Physicians Colorado LLC | Current |
Accepting new patients | |
| North Colorado Medical Center | Past | Accepting new patients | |
| Sterling Regional Medcenter | Past | Accepting new patients | |
| North Colorado Medical Center | Past | Accepting new patients |
Locations
2400 Edison St
Ste 101
Brush, CO 80723
Phone (970) 842-6262
2400 Edison St
Brush, CO 80723
Phone (970) 842-2833
4700 Lady Moon Dr
Fort Collins, CO 80528
Phone (970) 521-4600
909 E Railroad Ave
Ste 101
Fort Morgan, CO 80701
Phone (970) 542-4700
909 E Railroad Ave
Fort Morgan, CO 80701
Phone (970) 542-4700
1801 16th St
Greeley, CO 80631
Phone (970) 352-4121
Interoperability endpoints
- cdeckdo388603@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DR.0072886 | CO | Yes |
Addresses
Primary practice location
1801 16TH St
Greeley, CO 80631-5199
Mailing address
103 Bluebell CT
Wiggins, CO 80654-7923
Phone (217) 304-1492
Other providers in Greeley, CO
- Martha E De la Mora
- Cynthia M Dean
- Maryann Estell Dean
- Jeweliane N Deaver
- Akili Decamp
- Molly E Decker
- Lesley Thomas Deen
- Defined Dental & Dermal Spa PLLC
- Elise Dekraai
- Raquel Del Real
All providers in Greeley, CO · Family Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.