Individual provider Active NPI

Richard E Stockelman, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Colorado Springs, CO
National Provider Identifier
1811972854
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
32859 Issued in CO
Practice address
4110 Briargate Pkwy
Suite 300
Colorado Springs, CO 80920-7835
Phone
(719) 632-7669
Fax
(719) 632-0088
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 32859 CO
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 32859 CO Primary

Addresses

Primary practice location

4110 Briargate Pkwy
Suite 300
Colorado Springs, CO 80920-7835

Mailing address

4110 Briargate Pkwy
Suite 300
Colorado Springs, CO 80920-7835
Phone (719) 632-7669

Other identifiers 1

IdentifierTypeStateIssuer
01328590MedicaidCO

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
I20100127000553 CO Practitioner - Orthopedic Surgery 5193867638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
70.6
Promoting interoperability
99
Improvement activities
40
Cost
73.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32859COMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Springs Orthopaedic Group CurrentSince May 10, 2000 Accepting new patients
Colorado Springs Orthopaedic Group CurrentSince May 10, 2000 Accepting new patients
Colorado Springs Orthopaedic Group Current Accepting new patients
Audubon Ambulatory Surgery Center LLC PastSince Sep 10, 2008 Accepting new patients

Locations

1259 Lake Plaza Dr
Ste 100
Colorado Springs, CO 80906
Phone (719) 867-7335

4110 Briargate Pkwy
Ste 300
Colorado Springs, CO 80920
Phone (719) 867-7329

Interoperability endpoints

  • Direct secure messaging: rstockelman@csog.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1811972854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207835",
            "telephone_number": "719-632-7669",
            "fax_number": "719-632-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207835",
            "telephone_number": "719-632-7669",
            "fax_number": "719-632-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKELMAN",
        "first_name": "RICHARD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "32859",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CO",
            "license": "32859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01328590",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.