NPIMap

Individual provider Active NPI

Adam W. Kassner

  • Internal Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1760588941
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
49193 Issued in CO
Practice address
1400 E Boulder St
Colorado Springs, CO 80909
Phone
(719) 365-1292
Fax
(719) 365-6997
NPI assigned
Sep 15, 2006
Last updated
Jul 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 49193 CO Primary

Addresses

Primary practice location

1400 E Boulder St
Colorado Springs, CO 80909

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2403

Other identifiers 2

IdentifierTypeStateIssuer
P00358093OtherWARAILROAD
8176372MedicaidWA

Other names 1

  • Adam W. Kassner Professional name

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
I20111004000451 CO Practitioner - Internal Medicine 5799746509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 1992
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
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

4050 Briargate Pkwy
Colorado Springs, CO 80920-7815

4080 Briargate Pkwy
Colorado Springs, CO 80920-7815
Phone (719) 365-6800

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49193COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Aug 1, 2013 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 13, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 13, 2018 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Aug 1, 2013 Accepting new patients
Uch-MHS Past Accepting new patients

Locations

2350 Meadows Blvd
Castle Rock, CO 80109
Phone (720) 248-3413

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

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

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

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

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

Organizations & group practices 6

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1760588941",
    "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": "970-624-2403",
            "fax_number": "970-490-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "719-365-1292",
            "fax_number": "719-365-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSNER",
        "first_name": "ADAM",
        "middle_name": "W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "49193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00358093",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8176372",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADAM",
            "last_name": "KASSNER",
            "middle_name": "W.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.