Individual provider Active NPI

Michael Barry Stern, D.P.M.

  • Podiatrist
  • Northglenn, CO
National Provider Identifier
1962414797
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00275 Issued in CO
Practice address
10465 Melody Dr
Suite 313
Northglenn, CO 80234-4119
Phone
(303) 451-5900
Fax
(303) 451-1233
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 00275 CO Primary

Addresses

Primary practice location

10465 Melody Dr
Suite 313
Northglenn, CO 80234-4119

Mailing address

10465 Melody Dr
Suite 313
Northglenn, CO 80234-4119
Phone (303) 451-5900

Other identifiers 1

IdentifierTypeStateIssuer
01002757MedicaidCO

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

State licenses

LicenseStateTypeSpecialty
00275COMDPodiatrist
275COMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1962414797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10465 MELODY DR",
            "address_2": "SUITE 313",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344119",
            "telephone_number": "303-451-5900",
            "fax_number": "303-451-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10465 MELODY DR",
            "address_2": "SUITE 313",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344119",
            "telephone_number": "303-451-5900",
            "fax_number": "303-451-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "MICHAEL",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "00275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01002757",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; 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.