Individual provider Active NPI

Dwight Jonathan Slater, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Loveland, CO
National Provider Identifier
1912227927
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
0066720 Issued in CO
Practice address
2500 Rocky Mountain Ave Ste 360
Loveland, CO 80538-9004
Phone
(970) 221-1000
Fax
(970) 624-1892
NPI assigned
Jun 2, 2010
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301096225 MI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 35.133603 OH
Student in an Organized Health Care Education/Training Program 390200000X 4301096225 MI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 0066720 CO Primary

Addresses

Primary practice location

2500 Rocky Mountain Ave Ste 360
Loveland, CO 80538-9004

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2409

Other practice location 1

1800 15th St Ste 340B
Greeley, CO 80631-4500
Phone (970) 810-6953

Other practice location 2

1100 Central Park Dr Ste 1050
Steamboat Springs, CO 80487-8818
Phone (970) 870-1035

Other practice location 3

1760 E Ken Pratt Blvd Ste 205
Longmont, CO 80504-5311
Phone (720) 408-2369

Other practice location 4

2750 Broadway St Ste 2178
Boulder, CO 80304-3573
Phone (303) 440-3057

Other identifiers 1

IdentifierTypeStateIssuer
0281733MedicaidOH

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
I20210726003428 CO Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 0446480677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery, Vascular Surgery
Education
Michigan State University College of Human Medicine, 2010
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)

11083 Colorado Blvd
Firestone, CO 80504-5873
Phone (303) 833-8880

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

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

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
Coronary artery bypass graft (CABG)20
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0066720COMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35.133603OHMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Surgery Current Accepting new patients
Poudre Valley Medical Group, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Apr 1, 2024 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients
Medical Center of the Rockies Past Accepting new patients

Locations

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

2750 Broadway St
Ste 2170
Boulder, CO 80304
Phone (303) 440-3057

2750 Broadway St
Ste 2178
Boulder, CO 80304
Phone (303) 440-3057

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

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1760 E Ken Pratt Blvd
Ste 205
Longmont, CO 80504
Phone (720) 718-3930

2500 Rocky Mountain Ave
#360
Loveland, CO 80538

2500 Rocky Mountain Ave
Ste 360
Loveland, CO 80538
Phone (970) 221-5878

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

1100 Central Park Dr
Ste 1050
Steamboat Springs, CO 80487
Phone (970) 870-1035

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1912227927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE STE 360",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-221-1000",
            "fax_number": "970-624-1892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 15th St Ste 340B",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806314500",
            "country_code": "US",
            "telephone_number": "970-810-6953",
            "fax_number": "937-294-9010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Central Park Dr Ste 1050",
            "address_purpose": "LOCATION",
            "city": "Steamboat Springs",
            "state": "CO",
            "postal_code": "804878818",
            "country_code": "US",
            "telephone_number": "970-870-1035",
            "fax_number": "970-870-1036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1760 E Ken Pratt Blvd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805045311",
            "country_code": "US",
            "telephone_number": "720-408-2369",
            "fax_number": "720-718-5989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2750 Broadway St Ste 2178",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043573",
            "country_code": "US",
            "telephone_number": "303-440-3057",
            "fax_number": "303-440-3256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLATER",
        "first_name": "DWIGHT",
        "middle_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301096225",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "35.133603",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301096225",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CO",
            "license": "0066720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0281733",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.