Todd Zoltan, MD, JD
Individual provider Active NPI Family Medicine Physician · Peterson Space Force Base, CO
NPI 1831152685 · NPPES record last updated Feb 2, 2024
Key facts
- NPI
- 1831152685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- DR.0060167 (CO)
- Practice address
- 559 Vincent St.
Space Base Delta 1
Peterson Space Force Base, CO 80914 - Phone
- (303) 415-7599
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 34
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Boulder Community Health
Practice addresses (Care Compare)
6685 Gunpark Dr
Suite 110
Boulder, CO 80301-3343
Phone (303) 415-7599
Hospital & facility affiliations
- Boulder Community Health
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 |
|---|---|---|---|---|
| I20191221000224 | CO | Practitioner - Family Practice | 5496750051 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Juris Doctor, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Current |
Accepting new patients | |
| Boulder Community Health | Current |
Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current |
Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current |
Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients |
Locations
4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000
5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770
1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450
6685 Gunpark Dr
Boulder, CO 80301
Phone (303) 414-7599
6685 Gunpark Dr
Ste 110
Boulder, CO 80301
Phone (303) 415-7599
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
1400 E Boulder St
Ste 2508
Colorado Springs, CO 80909
Phone (719) 365-1292
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DR.0060167 | CO | Yes |
Addresses
Primary practice location
559 Vincent St.
Space Base Delta 1
Peterson Space Force Base, CO 80914
Mailing address
559 Vincent St.
Space Base Delta 1
Peterson Space Force Base, CO 80914
Other practice location 1
6685 Gunpark Dr
Boulder, CO 80301-3388
Phone (303) 414-7599
Other providers in Peterson Space Force Base, CO
All providers in Peterson Space Force Base, 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 Feb 2, 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.