NPIMap

Individual provider Active NPI

Matthew Gillen Duran, MD

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1861470577
Registry record updated Oct 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39325 Issued in CO
Practice address
1212 East Elizabeth Street
Fort Collins, CO 80524
Phone
(970) 482-2791
Fax
(970) 495-9843
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2009

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 39325 CO Primary

Addresses

Primary practice location

1212 East Elizabeth Street
Fort Collins, CO 80524

Mailing address

1321 Catalpa Drive
Fort Collins, CO 80521
Phone (970) 223-2469

Other identifiers 1

IdentifierTypeStateIssuer
19424033MedicaidCO

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
I20040622000276 CO Practitioner - Family Practice 7911998158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 1999
Medicare assignment
May accept Medicare assignment
Group practices
The Family Clinic of Fort CollinsGroup PAC ID 5890684179, 8 clinicians

Practice addresses (Care Compare)

1212 E Elizabeth St
Fort Collins, CO 80524-4007
Phone (970) 482-2791

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions35
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Clinic of Fort Collins Family Medicine CurrentSince Jan 16, 2006 Accepting new patients
Julie Devita-Bailey, D.O., P.C. Family Medicine Past Accepting new patients

Locations

1212 E Elizabeth St
Fort Collins, CO 80524
Phone (970) 482-2791

Organizations & group practices 2

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256256000000",
    "number": "1861470577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 CATALPA DRIVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80521",
            "telephone_number": "970-223-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 EAST ELIZABETH STREET",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80524",
            "telephone_number": "970-482-2791",
            "fax_number": "970-495-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "MATTHEW",
        "middle_name": "GILLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2009-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "39325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19424033",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.