Individual provider Active NPI

Michael D Waltz, M D

  • Anesthesiology Physician
  • Wheat Ridge, CO
National Provider Identifier
1871579516
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
41459 Issued in CO
Practice address
12911 W 40TH Ave
Wheat Ridge, CO 80401
Phone
(303) 425-4500
NPI assigned
Dec 15, 2005
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 41459 CO Primary

Addresses

Primary practice location

12911 W 40TH Ave
Wheat Ridge, CO 80401

Mailing address

PO Box 173656
Denver, CO 80217-3656
Phone (303) 425-4500

Other identifiers 1

IdentifierTypeStateIssuer
63455064MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100916001375 CO Practitioner - Anesthesiology 7618092420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Pittsburgh School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Anesthesia Services PCGroup PAC ID 7517947146, 112 clinicians

Practice addresses (Care Compare)

12911 W 40TH Ave
Golden, CO 80401-2696
Phone (303) 425-4500

3455 Lutheran Pkwy
Wheat Ridge, CO 80033-6028
Phone (303) 422-9438

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41459COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Anesthesia Services PC Anesthesiology CurrentSince Jul 1, 2003 Accepting new patients

Locations

1819 Denver West Dr
Ste 200
Lakewood, CO 80401
Phone 30342294381018

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

Organizations & group practices 1

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1871579516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173656",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173656",
            "telephone_number": "303-425-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 W 40TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "80401",
            "telephone_number": "303-425-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTZ",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "41459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63455064",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.