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MICHAEL LOUGHNER MD
NPI 1639216906
Internal Medicine - Endocrinology, Diabetes & Metabolism in Denver, CO

Active since January 30, 2007PECOS EnrolledAccepts Medicare Assignment
74.43/100
CMS Quality Rating
950 E HARVARD AVE, SUITE 660, DENVER, CO 80210(720) 399-6555(720) 399-6555 Get Directions Write a Review

NPPES record last updated: January 12, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Michael Loughner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL LOUGHNER MD (NPI 1639216906) is an individual endocrinology, diabetes & metabolism provider in Denver, Colorado, licensed in Colorado (44334) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Chicago College Of Medicine And Surgery (2003).

NPPES Registry Identity

NPI1639216906
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameMICHAEL LOUGHNERCredential: MD
Location Address950 E HARVARD AVE, SUITE 660Denver, CO 80210-7009
Mailing Address950 E Harvard Ave, Suite 660Denver, CO 80210-7009 · (720) 399-6555 · Fax (720) 399-0511
Phone(720) 399-6555
Fax(720) 399-6555
Sole ProprietorYes
Medical School CMSChicago College Of Medicine And SurgeryGraduated 2003
Enumeration DateJanuary 30, 2007
Last NPPES UpdateJanuary 12, 2016
✔ NPI 1639216906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in CO · 44334
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
950 E HARVARD AVE, Denver, CO 80210
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael Loughner Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608929195
PECOS Enrollment IDI20090730000611
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
1,195 services594 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
378 services133 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
98 services82 patients
Ultrasound scan of head and neck soft tissue 76536
An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.
84 services84 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
78 services53 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
61 services61 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$132.55 typical visit price
range $58.06 – $174.82
Typical copayment $33.13 (range $14.51 – $43.70)
Most-billed visit code 99204
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.43/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.72
Improvement Activities40
Cost52.48

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
24 suppliers51 claims268 services$6.37 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers13 claims29 services$1.13 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
10 suppliers226 claims236 services$183.56 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FOOT SPECIALIST ASSOCIATES P.C.
Podiatrist (Foot & Ankle Surgery)
950 E HARVARD AVE, 300
DENVER, CO 80210
Denver County (303) 722-6864
NEURODIAGNOSTICS GROUP, LLC
Specialist/Technologist, Other (Electroneurodiagnostic)
950 E HARVARD AVE, STE 570
DENVER, CO 80210
Denver County (303) 715-9024
DR. ADAM JONATHEN WOLFF M.D.
Psychiatry & Neurology (Neurology)
950 E HARVARD AVE, SUITE 570
DENVER, CO 80210
Denver County (303) 715-9024
JAMES SWINEHART MD
Specialist
950 E HARVARD AVE, SUITE 630
DENVER, CO 80210
Denver County (303) 744-7000
DR. JEFFREY A GIULLIAN M.D.
Internal Medicine (Nephrology)
950 E HARVARD AVE, SUITE 240
DENVER, CO 80210
Denver County (303) 871-0977
STEPHANIE WOMELDORF
Hearing Instrument Specialist
950 E HARVARD AVE, STE 620
DENVER, CO 80210
Denver County (303) 722-0886
PROFESSIONAL REFERRAL AND COUNSELLING SERVICE, INC.
Counselor (Mental Health)
950 E HARVARD AVE, SUITE 200
DENVER, CO 80210
Denver County (303) 733-2688
HARVARD PARK OPTICAL
Technician/Technologist (Optician)
950 E HARVARD AVE, SUITE 180
DENVER, CO 80210
Denver County (303) 777-7091

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Loughner's NPI number?

The NPI number for Michael Loughner is 1639216906. It was assigned to this individual provider in the NPPES registry on January 30, 2007.

Where is Michael Loughner located?

Michael Loughner practices at 950 E Harvard Ave Suite 660, Denver, CO 80210. The listed phone number is (720) 399-6555.

What is Michael Loughner's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Michael Loughner enrolled in Medicare?

Yes. Michael Loughner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Loughner accept?

Health plans from UnitedHealthcare list Michael Loughner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michael Loughner was last updated on January 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.