NPIMap

Individual provider Active NPI

Deric McIntosh, D.O.

  • Family Medicine Physician
  • Loveland, CO
National Provider Identifier
1942468129
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48280 Issued in CO
Practice address
1625 Foxtrail Dr Ste 190
Loveland, CO 80538-9089
Phone
(970) 619-6900
Fax
(970) 619-6990
NPI assigned
May 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 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 48280 CO Primary

Addresses

Primary practice location

1625 Foxtrail Dr Ste 190
Loveland, CO 80538-9089

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
I20111220000418 CO Practitioner - Family Practice 0042486151 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2695 Rocky Mountain Ave
Loveland, CO 80538-8702
Phone (970) 495-8490

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48280COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Colorado, Inc Family Medicine CurrentSince Jun 10, 2014 Accepting new patients
Associates in Family Medicine, P.C. Family Medicine CurrentSince Oct 2, 2022 Accepting new patients
Poudre Valley Health Care, Inc CurrentSince Aug 1, 2015 Accepting new patients
Poudre Valley Health Care Inc. Current Accepting new patients
Poudre Valley Health Care Inc CurrentSince Aug 1, 2015 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients

Locations

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

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

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

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

1625 Foxtrail Dr
Ste 190
Loveland, CO 80538
Phone (970) 500-2244

2695 Rocky Mountain Ave
Ste 200
Loveland, CO 80538
Phone (970) 495-8490

2500 Rocky Mountain Ave
Ste 2200
Loveland, CO 80538
Phone (970) 203-7250

1625 Foxtrail Dr
Ste 109
Loveland, CO 80538
Phone (970) 619-6900

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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 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": "1211587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1942468129",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 FOXTRAIL DR STE 190",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389089",
            "telephone_number": "970-619-6900",
            "fax_number": "970-619-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "DERIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-24",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "48280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.