Active NPI
Mark Andrew Teruel, MD
- Nephrology Physician
- Fort Collins, CO
National Provider Identifier
1972558039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 44625
- Practice address
- 3351 Eastbrook Dr Ste 100
Fort Collins, CO 80525-5744 - Phone
- (970) 493-7733
- Fax
- (970) 493-8745
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 44625 | CO | Primary |
Addresses
Primary practice location
3351 Eastbrook Dr Ste 100
Fort Collins, CO 80525-5744
Mailing address
3351 Eastbrook Dr Ste 100
Fort Collins, CO 80525-5744
Phone (970) 493-7733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20231351 | Medicaid | CO |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060706000263 | CO | Practitioner - Nephrology | 1153303763 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- University of Cincinnati College of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Nephrology Clinic PC
Practice addresses (Care Compare)
3351 Eastbrook Dr
Suite 100
Fort Collins, CO 80525-5744
Phone (970) 493-7733
Hospital & facility affiliations
- Northern Colorado Home Therapy Dialysis (FMC)
- Poudre Valley Hospital
- Medical Center of the Rockies
- Banner North Colorado Medical Center
- Uchealth Greeley Hospital
- Banner Fort Collins Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44625 | CO | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nephrology Clinic PC | Nephrology | Current | Accepting new patients |
| Fresenius Medical Care Dialysis Services Colorado, LLC | Past | Accepting new patients | |
| Fort Collins Skin Clinic, P.C. | Past | Accepting new patients |
Locations
1600 Specht Point Rd
Ste 127
Fort Collins, CO 80525
3351 Eastbrook Dr
Ste 100
Fort Collins, CO 80525
1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320
2988 Ginnala Dr
Loveland, CO 80538
Phone (970) 633-0815
620 Iris Dr
Sterling, CO 80751
Phone (970) 313-2740
Interoperability endpoints
- mhcs2053@yourcarecommunity.org
Organizations & group practices 3
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.
-
- Dermatology Physician
- Fort Collins, CO
- NPI 1619904943
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Denver, CO
- NPI 1316631633
Hospital & facility affiliations 32
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712793600000",
"number": "1972558039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3351 EASTBROOK DR STE 100",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255744",
"telephone_number": "970-493-7733",
"fax_number": "970-493-8745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3351 EASTBROOK DR STE 100",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255744",
"telephone_number": "970-493-7733",
"fax_number": "970-493-8745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERUEL",
"first_name": "MARK",
"middle_name": "ANDREW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2024-04-11",
"certification_date": "2024-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "CO",
"license": "44625",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20231351",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.