NPIMap

Individual provider Active NPI

Derrick Roth Fansler, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Colorado Springs, CO
National Provider Identifier
1760626519
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
DR.0053906 Issued in CO
Practice address
2222 N Nevada Ave
Suite 4007
Colorado Springs, CO 80907
Phone
(719) 776-8500
Fax
(719) 634-1448
NPI assigned
Apr 23, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 53906 CO
Clinical Cardiac Electrophysiology Physician 207RC0001X DR.0053906 CO Primary

Addresses

Primary practice location

2222 N Nevada Ave
Suite 4007
Colorado Springs, CO 80907

Mailing address

2222 N Nevada Ave
Suite 4007
Colorado Springs, CO 80907-6819
Phone (719) 776-8500

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
I20140930000335 CO Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9537398920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Northwestern University Feinberg Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CS Cardiology Newco LLCGroup PAC ID 2365805736, 46 clinicians

Practice addresses (Care Compare)

1625 Medical Ctr PT
Suite 210
Colorado Springs, CO 80907-5798
Phone (719) 960-0363

Hospital & facility affiliations

  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031
  • St Mary-Corwin Hospital Hospital, Pueblo, CO, CCN 060012
  • St Francis Hospital - Interquest Hospital, Colorado Springs, CO, CCN 060133
  • Heart of the Rockies Regional Medical Center Hospital, Salida, CO, CCN 061322
  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as group
Quality
92.26
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75.69 of 100Reported as group
Quality
71.4
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0053906COMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
CS Cardiology Newco LLC Cardiovascular Disease CurrentSince Oct 15, 2023 Accepting new patients
Colorado Springs Cardiology Heart & Vascular Center LLC Current Accepting new patients
CS Cardiology Newco LLC Cardiovascular Disease Current Accepting new patients
CS Cardiology Newco LLC Cardiovascular Disease CurrentSince Oct 15, 2023 Accepting new patients
CS Cardiology Newco LLC Cardiovascular Disease Past Accepting new patients
CS Cardiology Newco LLC Cardiovascular Disease Past Accepting new patients
CS Cardiology Newco LLC Cardiovascular Disease Past Accepting new patients

Locations

1625 Medical Center Pt
Ste 105
Colorado Springs, CO 80907

1625 Medical Center Pt
Ste 200
Colorado Springs, CO 80907
Phone (719) 630-3276

1625 Medical Center Pt
Ste 240
Colorado Springs, CO 80907
Phone (719) 577-9063

1625 Medical Center Pt
Ste 210
Colorado Springs, CO 80907
Phone (708) 289-4757

2222 N Nevada Ave
Ste 4007
Colorado Springs, CO 80907
Phone (719) 634-6671

1 Mercado St
Ste 130
Durango, CO 81301
Phone (970) 247-1120

904 E Hailey Ln
Ste C
Pueblo West, CO 81007

Organizations & group practices 8

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 11

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": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1760626519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE",
            "address_2": "SUITE 4007",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076819",
            "telephone_number": "719-776-8500",
            "fax_number": "719-634-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE",
            "address_2": "SUITE 4007",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-776-8500",
            "fax_number": "719-634-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANSLER",
        "first_name": "DERRICK",
        "middle_name": "ROTH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-23",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "53906",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CO",
            "license": "DR.0053906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.