NPIMap

Organization Active NPI

Northern Colorado Anesthesia Professionals PLLC

  • Anesthesiology Physician
  • Fort Collins, CO
National Provider Identifier
1851389613
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTHERN COLORADO ANESTHESIA PROFESSIONALS PLLC
Practice address
3702 Automation Way Ste 103
Fort Collins, CO 80525-5738
Phone
(970) 224-2985
Fax
(970) 223-1118
NPI assigned
Oct 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Shawn Wotowey
Title
Ceo
Phone
(970) 224-2985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738

Mailing address

3702 Automation Way
Suite 103
Fort Collins, CO 80525-5738
Phone (970) 224-2985

Other identifiers 5

IdentifierTypeStateIssuer
0225723OtherWAWORK COMP
04035054MedicaidCO
113844800MedicaidWY
187269700OtherCOFEDERAL WORK COMP
XX-XXXXXXX15MedicaidNE

Other names 1

  • NCAP, PLLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603001119 CO Part B Supplier - Clinic/Group Practice 6800878760 Receives reassigned benefits from 245 practitioners
Practice locations: Loveland, CO; Louisville, CO; Longmont, CO; Lafayette, CO; Fort Collins, CO; Greeley, CO

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1236 E Elizabeth St
Ste 1
Fort Collins, CO 80524
Phone (970) 484-6256

200 Exempla Cir
Ste 103
Lafayette, CO 80026

2255 S 88th St
Louisville, CO 80027
Phone (303) 666-2095

Practitioners & affiliated clinicians

Practitioners 257

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 257

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1851389613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY",
            "address_2": "SUITE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255738",
            "telephone_number": "970-224-2985",
            "fax_number": "970-223-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY STE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255738",
            "telephone_number": "970-224-2985",
            "fax_number": "970-223-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN COLORADO ANESTHESIA PROFESSIONALS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2024-04-01",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "WOTOWEY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-224-2985"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "0225723",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04035054",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113844800",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORK COMP",
            "identifier": "187269700",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XX-XXXXXXX15",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCAP, PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NCAP, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.