NPIMap

Individual provider Active NPI

Bryan Randolph Reider, D.O

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1861811663
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56390 Issued in CO
Practice address
1113 Oakridge Dr
Fort Collins, CO 80525-5591
Phone
(970) 225-0040
Fax
(970) 225-2996
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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 56390 CO Primary

Addresses

Primary practice location

1113 Oakridge Dr
Fort Collins, CO 80525-5591

Mailing address

1300 Riverside Ave Ste 102
Fort Collins, CO 80524-4351
Phone (970) 224-1670

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
I20170818000645 CO Practitioner - Family Practice 6800014226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1100 E Prospect Rd
BLDG a
Fort Collins, CO 80525-5304
Phone (970) 297-6630

1106 E Prospect Rd
Building B Suite 100
Fort Collins, CO 80525-5304
Phone (970) 495-7410

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

2121 E Harmony Rd
Fort Collins, CO 80528-3401

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions26
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56390COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Family Medicine, P.C. Family Medicine CurrentSince Oct 2, 2022 Accepting new patients
VMD Primary Providers Colorado, Inc Family Medicine CurrentSince Jul 25, 2017 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 7, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 7, 2025 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1106 E Prospect Rd
Ste 100
Fort Collins, CO 80525
Phone (970) 224-3636

1300 Riverside Ave
Ste 102
Fort Collins, CO 80524
Phone (970) 224-1670

1100 E Prospect Rd
Bldg A
Fort Collins, CO 80525
Phone (970) 297-6630

3519 Richmond Dr
Fort Collins, CO 80526
Phone (970) 204-0300

1106 E Prospect Rd
Fort Collins, CO 80525
Phone (970) 490-4476

1113 Oakridge Dr
Fort Collins, CO 80525
Phone (970) 225-0040

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1861811663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 RIVERSIDE AVE STE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244351",
            "telephone_number": "970-224-1670",
            "fax_number": "970-495-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 OAKRIDGE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255591",
            "telephone_number": "970-225-0040",
            "fax_number": "970-225-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDER",
        "first_name": "BRYAN",
        "middle_name": "RANDOLPH",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "56390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.