Individual provider Active NPI

Gary Paul Stec, MD

  • Internal Medicine Physician
  • Boulder, CO
National Provider Identifier
1912979709
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39417 Issued in CO
Practice address
4879 Valkyrie Dr
Boulder, CO 80301-4356
Phone
(303) 916-9919
Fax
(303) 516-4871
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39417 CO Primary

Addresses

Primary practice location

4879 Valkyrie Dr
Boulder, CO 80301-4356

Mailing address

4879 Valkyrie Dr
Boulder, CO 80301-4356
Phone (303) 916-9919

Other identifiers 1

IdentifierTypeStateIssuer
24632830MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26079MNMDClinical Social Worker
39417COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health Past Accepting new patients
Critical Care & Pulmonary Consultants, PC PastSince Jul 1, 2002 Accepting new patients
Monte Sol Medical Group Internal Medicine Past Accepting new patients
Philippe G Lopez MD PC PastSince Jun 16, 2024 Accepting new patients
Boulder Ekg Internal Medicine Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1912979709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4879 VALKYRIE DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803014356",
            "telephone_number": "303-916-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4879 VALKYRIE DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803014356",
            "telephone_number": "303-916-9919",
            "fax_number": "303-516-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEC",
        "first_name": "GARY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "39417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24632830",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.