Intermountain Health Good Samaritan Hospital - Medicare Primary Care in Lafayette, CO

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Intermountain Health Good Samaritan Hospital is a medicare enrolled primary clinic (General Acute Care Hospital) in Lafayette, Colorado. The current practice location for Intermountain Health Good Samaritan Hospital is 200 Exempla Cir, Lafayette, Colorado. For appointments, you can reach them via phone at (303) 689-4000. The mailing address for Intermountain Health Good Samaritan Hospital is 500 Eldorado Blvd, Ste 6250, Broomfield, Colorado and phone number is (303) 272-0820.

Intermountain Health Good Samaritan Hospital is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1043250780. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (303) 689-4000.

Contact Information

Intermountain Health Good Samaritan Hospital
200 Exempla Cir
Lafayette
CO 80026-3370
(303) 689-4000
(303) 467-4156

Map and Direction


Primary Care Clinic Profile

Full NameIntermountain Health Good Samaritan Hospital
SpecialityGeneral Acute Care Hospital
Location200 Exempla Cir, Lafayette, Colorado
Authorized Official Name and PositionSean Fadden (VP FINANCE)
Authorized Official Contact3034252410
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Intermountain Health Good Samaritan Hospital
500 Eldorado Blvd
Ste 6250
Broomfield
CO 80021-3408

Ph: (303) 272-0820		Intermountain Health Good Samaritan Hospital
200 Exempla Cir
Lafayette
CO 80026-3370

Ph: (303) 689-4000

NPI Details:

NPI Number1043250780
Provider Enumeration Date06/08/2006
Last Update Date10/17/2023

Medicare PECOS Information:

Medicare PECOS PAC ID7618995275
Medicare Enrollment IDO20051102001154

Medical Identifiers

Medical identifiers for Intermountain Health Good Samaritan Hospital such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043250780NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Secondary
207RC0000XInternal Medicine - Cardiovascular Disease (* (Not Available))Secondary
207RC0200XInternal Medicine - Critical Care Medicine (* (Not Available))Secondary
207V00000XObstetrics & Gynecology (* (Not Available))Secondary
208000000XPediatrics (* (Not Available))Secondary
208600000XSurgery (* (Not Available))Secondary
2086S0127XSurgery - Trauma Surgery (* (Not Available))Secondary
282N00000XGeneral Acute Care Hospital (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Intermountain Health Good Samaritan Hospital acts as a billing entity for following providers:
Provider NameStephen P Johnson
Provider TypePractitioner - Interventional Radiology
Provider IdentifiersNPI Number: 1972688505
PECOS PAC ID: 6800700618
Enrollment ID: I20031117000342
Provider NameMichael J Podolak
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1447262852
PECOS PAC ID: 9335044890
Enrollment ID: I20031206000119
Provider NameChristopher Aaron Bates
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1841327889
PECOS PAC ID: 2567459308
Enrollment ID: I20040426001202
Provider NameMana K Amir
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1598731994
PECOS PAC ID: 0749250728
Enrollment ID: I20040728000114
Provider NameLisa D Ahrendt
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1851381487
PECOS PAC ID: 9133182702
Enrollment ID: I20041105000213
Provider NameRenee J Kallesen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194852020
PECOS PAC ID: 8729031497
Enrollment ID: I20050223000357
Provider NameMatthew D Suskin
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1023093440
PECOS PAC ID: 4880645530
Enrollment ID: I20050711000299
Provider NameSamay A Dalal
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1073650347
PECOS PAC ID: 7416057252
Enrollment ID: I20070710000392
Provider NameRajan K Gupta
Provider TypePractitioner - Interventional Radiology
Provider IdentifiersNPI Number: 1952457574
PECOS PAC ID: 3971695354
Enrollment ID: I20070815000849
Provider NamePatricia Sato
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1477697266
PECOS PAC ID: 3870663081
Enrollment ID: I20080530000386
Provider NameAmit Sudan
Provider TypePractitioner - Interventional Radiology
Provider IdentifiersNPI Number: 1689660953
PECOS PAC ID: 8628067048
Enrollment ID: I20080708000155
Provider NameKelly P Knudson
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1104972884
PECOS PAC ID: 0840364048
Enrollment ID: I20080806000517
Provider NameScott R Valent
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1013975887
PECOS PAC ID: 6406944388
Enrollment ID: I20090407000025
Provider NameChristopher G Johnnides
Provider TypePractitioner - Vascular Surgery
Provider IdentifiersNPI Number: 1841257706
PECOS PAC ID: 6901832138
Enrollment ID: I20090430000030
Provider NameVadim Fayngersh
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1437146115
PECOS PAC ID: 9133155062
Enrollment ID: I20090716000251
Provider NameJanet R Suarez
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1063494615
PECOS PAC ID: 3173559671
Enrollment ID: I20090723000726
Provider NameMitchell T Smith
Provider TypePractitioner - Interventional Radiology
Provider IdentifiersNPI Number: 1538215215
PECOS PAC ID: 5799830857
Enrollment ID: I20090826000443
Provider NamePaul A Stangl
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1114916921
PECOS PAC ID: 3971530288
Enrollment ID: I20100609000673
Provider NameLaurie L Carr
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1346287968
PECOS PAC ID: 7618989575
Enrollment ID: I20100614000443
Provider NamePatrick J Bushard
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1306998448
PECOS PAC ID: 9335334242
Enrollment ID: I20101117000233
Provider NameAndrew C Porter
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1427224427
PECOS PAC ID: 8022295823
Enrollment ID: I20110603000202
Provider NameJonathan-hien Vu
Provider TypePractitioner - Vascular Surgery
Provider IdentifiersNPI Number: 1356315139
PECOS PAC ID: 9133303936
Enrollment ID: I20110804000350
Provider NameKarng S Log
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1932310034
PECOS PAC ID: 1153486246
Enrollment ID: I20111121000792
Provider NameCatherine Lazar
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1992992440
PECOS PAC ID: 9133250988
Enrollment ID: I20130830000730
Provider NameEmily S Stanton
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1982869822
PECOS PAC ID: 5799009577
Enrollment ID: I20150127001565
Provider NameChristopher B Jones
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1700876992
PECOS PAC ID: 4385716703
Enrollment ID: I20150609000627
Provider NameEmerson E Sharpe
Provider TypePractitioner - Interventional Radiology
Provider IdentifiersNPI Number: 1750518353
PECOS PAC ID: 5698905172
Enrollment ID: I20150829000013
Provider NameKristy Ann Bauman
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1356427801
PECOS PAC ID: 2567539646
Enrollment ID: I20161228000160
Provider NameOra M Fried
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1750597373
PECOS PAC ID: 8224184676
Enrollment ID: I20170201000844
Provider NameLisa Richman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1629211230
PECOS PAC ID: 1355658972
Enrollment ID: I20170927000126
Provider NameSondra L Miles
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1174849962
PECOS PAC ID: 6507093606
Enrollment ID: I20180710000642

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.