| Mt. San Rafael Hospital Clinic | |
|
400 Benedicta Ave Trinidad CO 81082-2099 | |
| (719) 845-3168 | |
| (719) 845-4243 |
| Full Name | Mt. San Rafael Hospital Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 400 Benedicta Ave, Trinidad, Colorado |
| Authorized Official Name and Position | Kathy Topping (PFS DIRECTORE) |
| Authorized Official Contact | 7198453168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt. San Rafael Hospital Clinic 410 Benedicta Avenue Trinidad CO 81082 Ph: (719) 846-9213 | Mt. San Rafael Hospital Clinic 400 Benedicta Ave Trinidad CO 81082-2099 Ph: (719) 845-3168 |
| NPI Number | 1467400309 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 04/04/2023 |
| Medicare PECOS PAC ID | 2769394055 |
|---|---|
| Medicare Enrollment ID | O20031111000178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467400309 | NPI | - | NPPES |
| Provider Name | Kevin L Mcclintock |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366400178 PECOS PAC ID: 6608776729 Enrollment ID: I20040113000460 |
| Provider Name | Sally L Fabec |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427093111 PECOS PAC ID: 5991606691 Enrollment ID: I20040115001093 |
| Provider Name | Leslie G Frederiksen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720015324 PECOS PAC ID: 2860474046 Enrollment ID: I20040602000683 |
| Provider Name | Christopher L Poland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447356191 PECOS PAC ID: 8729058367 Enrollment ID: I20040729001238 |
| Provider Name | Joseph Patrick Jimenez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366400681 PECOS PAC ID: 7315917259 Enrollment ID: I20050105000950 |
| Provider Name | Renee Anderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457339848 PECOS PAC ID: 0143271411 Enrollment ID: I20050525000685 |
| Provider Name | Charles Joseph Moss |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962486829 PECOS PAC ID: 9335181783 Enrollment ID: I20050525000748 |
| Provider Name | Steven B Swanson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467406751 PECOS PAC ID: 0749214369 Enrollment ID: I20050922001273 |
| Provider Name | David A Hudson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992836910 PECOS PAC ID: 0840215299 Enrollment ID: I20051013001061 |
| Provider Name | Valerie Jean Borsa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265490676 PECOS PAC ID: 0648281535 Enrollment ID: I20060505000945 |
| Provider Name | Precious Sheryll V Castro Flores |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568411718 PECOS PAC ID: 8729090691 Enrollment ID: I20060613000313 |
| Provider Name | Jose M Flores |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265481410 PECOS PAC ID: 3274545157 Enrollment ID: I20060613000321 |
| Provider Name | James A Conrad |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316983083 PECOS PAC ID: 6608879515 Enrollment ID: I20060815000310 |
| Provider Name | Lynne Marie Cappellucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952407744 PECOS PAC ID: 0143226407 Enrollment ID: I20061010000045 |
| Provider Name | Alexander Sutherland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871572115 PECOS PAC ID: 0840299095 Enrollment ID: I20061215000444 |
| Provider Name | Arthur W Brehm |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992775241 PECOS PAC ID: 9133215908 Enrollment ID: I20071010000363 |
| Provider Name | David Paz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467536300 PECOS PAC ID: 7012004989 Enrollment ID: I20071025000156 |
| Provider Name | James M Glass |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114968567 PECOS PAC ID: 9436239795 Enrollment ID: I20071228000206 |
| Provider Name | Thomas P Goodell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639266950 PECOS PAC ID: 3274527197 Enrollment ID: I20080603000359 |
| Provider Name | Jeffrey L Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588625156 PECOS PAC ID: 9436215175 Enrollment ID: I20090305000077 |
| Provider Name | Prashant Krishnan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689883993 PECOS PAC ID: 3274622881 Enrollment ID: I20100204000688 |
| Provider Name | Paul L Tennery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700812450 PECOS PAC ID: 5991768350 Enrollment ID: I20100616000120 |
| Provider Name | Bhaktasharan C Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053415463 PECOS PAC ID: 8820070238 Enrollment ID: I20100927000498 |
| Provider Name | Lukasz M Kowalczyk |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1104913003 PECOS PAC ID: 1557555190 Enrollment ID: I20101028000122 |
| Provider Name | Thomas J Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649464439 PECOS PAC ID: 7012084247 Enrollment ID: I20101028001510 |
| Provider Name | Sherri Lynne Musgrave |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649583964 PECOS PAC ID: 1850371592 Enrollment ID: I20101029000575 |
| Provider Name | Joseph P Moore |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972607067 PECOS PAC ID: 7214022706 Enrollment ID: I20110119000208 |
| Provider Name | Kelly E Gahan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396957908 PECOS PAC ID: 8426180134 Enrollment ID: I20110804000335 |
| Provider Name | Theresa Keefer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477857274 PECOS PAC ID: 8628249000 Enrollment ID: I20110914000739 |
| Provider Name | Heather I Cook |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255547691 PECOS PAC ID: 2860564515 Enrollment ID: I20111013000372 |
| Provider Name | David Roland Reitter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639156177 PECOS PAC ID: 6507918802 Enrollment ID: I20111207000704 |
| Provider Name | Mary Hund-snyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376538082 PECOS PAC ID: 2062670128 Enrollment ID: I20120221000039 |
| Provider Name | Megan Colleen Mcneil |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487933396 PECOS PAC ID: 0547429987 Enrollment ID: I20120305000524 |
| Provider Name | Douglas Mcfarland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992863195 PECOS PAC ID: 8325179377 Enrollment ID: I20120405000721 |
| Provider Name | David Serafini |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1316991052 PECOS PAC ID: 4981627825 Enrollment ID: I20120516000300 |
| Provider Name | James Eric Rose |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740299957 PECOS PAC ID: 7113971342 Enrollment ID: I20131023000755 |
| Provider Name | Maria L Duran-shy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275833667 PECOS PAC ID: 0345475372 Enrollment ID: I20131030000036 |
| Provider Name | Angela J Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750362547 PECOS PAC ID: 3173763323 Enrollment ID: I20131207000288 |
| Provider Name | Anju K Sidhu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114058344 PECOS PAC ID: 5597811125 Enrollment ID: I20140129000360 |
| Provider Name | Kara K Leach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790074706 PECOS PAC ID: 8325296486 Enrollment ID: I20140729000643 |
| Provider Name | Michael William Noonan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902071202 PECOS PAC ID: 8022141886 Enrollment ID: I20140820002567 |
| Provider Name | Dario B San Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528462975 PECOS PAC ID: 7618290511 Enrollment ID: I20141230000499 |
| Provider Name | Jill S Murphey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962403782 PECOS PAC ID: 6800999319 Enrollment ID: I20150212000249 |
| Provider Name | Robert Christopher Harmon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669684643 PECOS PAC ID: 8527236009 Enrollment ID: I20150302000266 |
| Provider Name | Vanessa Daisy Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912111691 PECOS PAC ID: 2062567720 Enrollment ID: I20150302000412 |
| Provider Name | Elizabeth Stewart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114998226 PECOS PAC ID: 9638357668 Enrollment ID: I20160428001056 |
| Provider Name | Lana Geier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902001985 PECOS PAC ID: 4688973365 Enrollment ID: I20160502001002 |
| Provider Name | Katherine Marie Broman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780663294 PECOS PAC ID: 7911890249 Enrollment ID: I20161019001061 |
| Provider Name | Jose Mantilla Acevedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720394612 PECOS PAC ID: 3577752013 Enrollment ID: I20161020000128 |
| Provider Name | Abigail Norris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578983623 PECOS PAC ID: 3870879786 Enrollment ID: I20171002000158 |
| Provider Name | Jennifer Jo Keto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871011320 PECOS PAC ID: 9436424199 Enrollment ID: I20171005000594 |
| Provider Name | Lindsey L Mochel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245780949 PECOS PAC ID: 1456634047 Enrollment ID: I20171207000794 |
| Provider Name | Martha Cheatwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528001047 PECOS PAC ID: 3678599669 Enrollment ID: I20180221002310 |
| Provider Name | Lucy O Norrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982107207 PECOS PAC ID: 8628331998 Enrollment ID: I20180419001111 |
| Provider Name | Kevin S Diamond |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598131559 PECOS PAC ID: 9830405216 Enrollment ID: I20180502000539 |
| Provider Name | Timothy W Hegeman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285990184 PECOS PAC ID: 5799910352 Enrollment ID: I20180705001383 |
| Provider Name | Damian N Mizera |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750484838 PECOS PAC ID: 2961408307 Enrollment ID: I20180905000510 |
| Provider Name | Douglas Long Nguyen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184880114 PECOS PAC ID: 5698811230 Enrollment ID: I20190214002498 |
| Provider Name | Luis Santiago-rosado |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366739674 PECOS PAC ID: 8729356134 Enrollment ID: I20190228002573 |
| Provider Name | Morgan Shier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164872032 PECOS PAC ID: 9032403639 Enrollment ID: I20191112001707 |
| Provider Name | James W Bowie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720581523 PECOS PAC ID: 0042566572 Enrollment ID: I20191213000560 |
| Provider Name | Tropha A Wright |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053511303 PECOS PAC ID: 3072745199 Enrollment ID: I20220225001107 |
| Provider Name | Jeff Hansen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124099577 PECOS PAC ID: 3577557420 Enrollment ID: I20230214003383 |
| Provider Name | Tonya Fife |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184697047 PECOS PAC ID: 2668767229 Enrollment ID: I20230707002226 |
| Provider Name | Patrick Basu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053396572 PECOS PAC ID: 0143260646 Enrollment ID: I20231211001411 |
Mt. Carmel Health & Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 Robinson Ave, Trinidad, CO 81082 Phone: 719-845-4880 | |
Health Solutions Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 910 E Main St, Trinidad, CO 81082 Phone: 719-545-2746 | |
N/a Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Benedicta Ave, Suite E, Trinidad, CO 81082 Phone: 719-845-0627 Fax: 719-845-0663 | |
Santa Fe Trail Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Waverly Ave, Trinidad, CO 81082 Phone: 505-647-8366 Fax: 505-647-8381 | |
Mt Carmel Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 Robinson Ave, Trinidad, CO 81082 Phone: 719-845-4800 Fax: 866-712-1013 | |
Sally L. Fabec, M. D. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 328 S Bonaventure Ave, Suite 5, Trinidad, CO 81082 Phone: 719-846-4433 Fax: 719-846-8350 | |
Health Care Partners Foundation Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2309 E Main St, Trinidad, CO 81082 Phone: 888-201-1499 |