Individual provider Active NPI

Marc H Seidman, MD

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1982680088
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0038498 Issued in CO
Practice address
1635 Blue Spruce Dr
Fort Collins, CO 80524-5427
Phone
(970) 494-4040
Fax
(970) 494-4076
NPI assigned
Dec 20, 2005
Last updated
Nov 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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 DR.0038498 CO Primary

Addresses

Primary practice location

1635 Blue Spruce Dr
Fort Collins, CO 80524-5427

Mailing address

203 S Rollie Ave
Fort Lupton, CO 80621-1508
Phone (303) 286-4560

Other identifiers 1

IdentifierTypeStateIssuer
56131062MedicaidCO

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
I20050211000328 CO Practitioner - Family Practice 2668424276 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0038498COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Family Health CurrentSince May 26, 2010 Accepting new patients
Salud Family Health CurrentSince May 26, 2010 Accepting new patients
Salud Family Health Past Accepting new patients
Salud Family Health Past Accepting new patients

Locations

1635 Blue Spruce Dr
Fort Collins, CO 80524
Phone (970) 494-4040

203 S Rollie Ave
Fort Lupton, CO 80621
Phone (303) 286-4560

5995 Iris Pkwy
Frederick, CO 80504
Phone (303) 833-2050

Interoperability endpoints

  • Direct secure messaging: marc.seidman@sfhc.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1982680088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-286-4560",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 BLUE SPRUCE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805245427",
            "telephone_number": "970-494-4040",
            "fax_number": "970-494-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDMAN",
        "first_name": "MARC",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0038498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56131062",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.