NPIMap

Individual provider Active NPI

Douglas Bruce Deyoung, DO

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1811989064
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27536 Issued in CO
Practice address
313 W Drake Rd
Fort Collins, CO 80526-2846
Phone
(970) 482-8881
Fax
(970) 482-9646
NPI assigned
Aug 15, 2005
Last updated
Nov 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27536 CO Primary

Addresses

Primary practice location

313 W Drake Rd
Fort Collins, CO 80526-2846

Mailing address

4674 Snow Mesa Dr
Ste 140
Fort Collins, CO 80528-8615
Phone (970) 225-5043

Other identifiers 2

IdentifierTypeStateIssuer
DE27536OtherCOBCBS
1275361MedicaidCO

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
I20071119000342 CO Practitioner - Family Practice 9830113703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mountain View Family MedicineGroup PAC ID 9830160225, 4 clinicians

Practice addresses (Care Compare)

2121 E Harmony Rd
Unit 310
Fort Collins, CO 80528-3403
Phone (970) 221-3855

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27536COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Family Medicine Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Bender Medical Group Inc Family Medicine CurrentSince Oct 11, 2010 Accepting new patients
Julie Devita-Bailey, D.O., P.C. Family Medicine Past Accepting new patients
Family Physical Therapy Center, P.C. Past Accepting new patients
Deyoung Family Medicine LLC Family Medicine PastSince Nov 1, 2007 Accepting new patients

Locations

2121 E Harmony Rd
Unit 310
Fort Collins, CO 80528
Phone (970) 221-3855

313 W Drake Rd
Fort Collins, CO 80526
Phone (970) 225-5027

313 W Drake Rd
Ste 100
Fort Collins, CO 80526
Phone (970) 225-5028

4674 Snow Mesa Dr
Ste 140
Fort Collins, CO 80528
Phone (970) 225-5000

Organizations & group practices 5

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1811989064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "STE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-225-5043",
            "fax_number": "970-482-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W DRAKE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262846",
            "telephone_number": "970-482-8881",
            "fax_number": "970-482-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "DOUGLAS",
        "middle_name": "BRUCE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "27536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "DE27536",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275361",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.