Individual provider Active NPI

Stephen B Siegel, M. D.

  • Urology Physician
  • Boulder, CO
National Provider Identifier
1902860091
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
040149 Issued in CT
Practice address
2750 Broadway St
Boulder, CO 80304-3573
Phone
(303) 440-3093
Fax
(303) 440-3161
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 040149 CT Primary

Addresses

Primary practice location

2750 Broadway St
Boulder, CO 80304-3573

Mailing address

1579 Straits Tpke
Suite 2a
Middlebury, CT 06762-1835
Phone (203) 757-8361

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
I20181113000222 CO Practitioner - Urology 3577579887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Vanderbilt University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Medical Center, PCGroup PAC ID 4183536204, 86 clinicians

Practice addresses (Care Compare)

2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3000

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040149CTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Medical Center, P.C. Current Accepting new patients
Boulder Medical Center, P.C. CurrentSince Nov 1, 2018 Accepting new patients
Boulder Medical Center, P.C. CurrentSince Nov 1, 2018 Accepting new patients
Atlanta Urology Associates, P.C. Urology Past Accepting new patients
Medical Center Pharmacy Inc Past Accepting new patients
Atlanta Wellness MD PC Urology Past Accepting new patients

Locations

2750 Broadway St
Boulder, CO 80304
Phone (303) 440-3000

4745 Arapahoe Ave
Ste 200
Boulder, CO 80303
Phone (303) 938-4710

Organizations & group practices 6

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1902860091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TPKE",
            "address_2": "SUITE 2A",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621835",
            "telephone_number": "203-757-8361",
            "fax_number": "203-754-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-440-3093",
            "fax_number": "303-440-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "STEPHEN",
        "middle_name": "B",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CT",
            "license": "040149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.