Stout Street Clinic - Medicare Primary Care in Denver, CO

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Stout Street Clinic is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Denver, Colorado. The current practice location for Stout Street Clinic is 2130 Stout St, Denver, Colorado. For appointments, you can reach them via phone at (303) 293-2220. The mailing address for Stout Street Clinic is 2111 Champa St, Denver, Colorado and phone number is (303) 293-2217.

Stout Street Clinic is licensed to practice in NU (license number ). The clinic also participates in the medicare program and its NPI number is 1396793030. 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) 293-2220.

Contact Information

Stout Street Clinic
2130 Stout St
Denver
CO 80205-2827
(303) 293-2220
(303) 293-6966

Map and Direction


Primary Care Clinic Profile

Full NameStout Street Clinic
SpecialityClinic/Center
Location2130 Stout St, Denver, Colorado
Authorized Official Name and PositionPete J Stoller (CFO)
Authorized Official Contact3033129606
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Stout Street Clinic
2111 Champa St
Denver
CO 80205-2529

Ph: (303) 293-2217		Stout Street Clinic
2130 Stout St
Denver
CO 80205-2827

Ph: (303) 293-2220

NPI Details:

NPI Number1396793030
Provider Enumeration Date05/05/2006
Last Update Date01/02/2025
Certification Date01/02/2025

Medicare PECOS Information:

Medicare PECOS PAC ID7618958687
Medicare Enrollment IDO20040526000359

Medical Identifiers

Medical identifiers for Stout Street Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396793030NPI-NPPES
05638390MedicaidCO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center 1042 (Colorado)Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (NU)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Stout Street Clinic acts as a billing entity for following providers:
Provider NameSamantha Amanda Cook
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1730294612
PECOS PAC ID: 5496851677
Enrollment ID: I20070504000106
Provider NameLisa M Conner
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1396946448
PECOS PAC ID: 7911187992
Enrollment ID: I20110208000679
Provider NameLia a Fiallos
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1861743379
PECOS PAC ID: 1658684352
Enrollment ID: I20150827003198
Provider NameAnya J Miller
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1932426483
PECOS PAC ID: 2860625779
Enrollment ID: I20151020000577
Provider NameMadeline Alene Graber
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1043716269
PECOS PAC ID: 6901133958
Enrollment ID: I20190813003515
Provider NameRachelle Stroh
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1033622014
PECOS PAC ID: 2264842210
Enrollment ID: I20201103002595
Provider NameKaitlin Fosse
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1760052559
PECOS PAC ID: 7618378217
Enrollment ID: I20210701003210
Provider NameCharles Lutz-priefert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639545312
PECOS PAC ID: 9931505047
Enrollment ID: I20210914003264
Provider NameKandice Nichole Eakes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760770358
PECOS PAC ID: 8022283993
Enrollment ID: I20220804003237
Provider NameKaren L Spring
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871730093
PECOS PAC ID: 5698822385
Enrollment ID: I20220805001318
Provider NameAatif Mansoor
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1033641709
PECOS PAC ID: 0547535460
Enrollment ID: I20220816001757
Provider NameKristin N Pashia
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1811579360
PECOS PAC ID: 6608275276
Enrollment ID: I20220826000669
Provider NameThomas Sean O'toole
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1548732209
PECOS PAC ID: 7517318272
Enrollment ID: I20240105004023
Provider NameJacob Arrowsmith
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1912749110
PECOS PAC ID: 5395211403
Enrollment ID: I20260416001691
Provider NameMia Ellen Field
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1245884287
PECOS PAC ID: 4183190069
Enrollment ID: I20260417001725
Provider NameKerigan Flynn
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1790417491
PECOS PAC ID: 4082180666
Enrollment ID: I20260421001130
Provider NameJacob Wessley
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1265804850
PECOS PAC ID: 5395211981
Enrollment ID: I20260421001468
Provider NameDouglas Newel Calkin
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1861715500
PECOS PAC ID: 3870060890
Enrollment ID: I20260428001207
Provider NameMaggie Rosen
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1366138554
PECOS PAC ID: 3870061351
Enrollment ID: I20260504004733
Provider NameMicah Bear Friedlander
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1013435791
PECOS PAC ID: 5496223927
Enrollment ID: I20260504005952
Provider NameLaura Streeten
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1831860782
PECOS PAC ID: 5890263834
Enrollment ID: I20260507001614
Provider NameJillian Marie Couto
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1417684028
PECOS PAC ID: 0244700078
Enrollment ID: I20260521003642

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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.