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MICHAEL J FALL DO
NPI 1851548648
Internal Medicine - Pulmonary Disease in Denver, CO

Active since August 22, 2008PECOS EnrolledAccepts Medicare Assignment
535 16TH ST, STE 750, DENVER, CO 80202(303) 825-4646(303) 825-3215 Get Directions Write a Review

NPPES record last updated: June 6, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Michael J Fall Do NPPES

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

MICHAEL J FALL DO (NPI 1851548648) is an individual pulmonary disease provider in Denver, Colorado, licensed in Idaho (O-1046) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Philadelphia College Of Osteopathic Medicine (2006).

NPPES Registry Identity

NPI1851548648
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameMICHAEL J FALLCredential: DO
Location Address535 16TH ST, STE 750Denver, CO 80202-4228
Mailing Address535 16th St, Ste 750Denver, CO 80202-4228 · (303) 825-4646 · Fax (303) 825-3215
Phone(303) 825-4646
Fax(303) 825-3215
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2006
Enumeration DateAugust 22, 2008
Last NPPES UpdateJune 6, 2017
✔ NPI 1851548648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in ID · O-1046
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 47743 (CO)
535 16TH ST, Denver, CO 80202
Open in Google Maps ↗

Other Identifiers 1

Medicaid12783340CO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.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 J Fall Do 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 ID9032260948
PECOS Enrollment IDI20170714002425
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 9

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
92 services32 patients
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.
46 services40 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.
27 services27 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.
27 services25 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
22 services22 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.
22 services22 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130006
Location190 East Bannock StreetBoise, ID 83712 · Ada County
Emergency services Birthing friendly

St Luke's Nampa Medical Center

Acute Care Hospitals · Nampa, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130071
Location9850 West St Lukes DriveNampa, ID 83687 · Canyon County
Emergency services Birthing friendly

St Luke's Elmore Medical Center

Critical Access Hospitals · Mountain Home, ID
OwnershipVoluntary non-profit - Private
CMS Certification Number131311
Location895 North 6th EastMountain Home, ID 83647 · Elmore County
Emergency services Birthing friendly

St Luke's Mccall

Critical Access Hospitals · Mccall, ID
OwnershipProprietary
CMS Certification Number131312
Location1000 State StreetMccall, ID 83638 · Valley County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80202 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.

Referred Medical Equipment & Supplies CMS DME claims 16

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
10 suppliers80 claims80 services$35.34 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
8 suppliers59 claims59 services$80.04 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
8 suppliers56 claims146 services$31.17 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers29 claims109 services$17.74 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
4 suppliers11 claims56 services$12.89 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
7 suppliers43 claims43 services$50.29 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 5

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

SAM FERSZT MD
Internal Medicine
535 16TH ST, STE 750
DENVER, CO 80202
Denver County (303) 825-4646
LLOYD CHIROPRACTIC PC
Chiropractor
535 16TH ST, SUITE 200
DENVER, CO 80202
Denver County (303) 371-5280
DR. JOHN CHRIS HORNSBY MD
Hospitalist
535 16TH ST, SUITE 750
DENVER, CO 80202
Denver County (303) 825-4646
INTEGRATIVE HEALTH INC
Acupuncturist
535 16TH ST, SUITE 280
DENVER, CO 80202
Denver County (720) 523-0630
DR. AMY JEANNE ESPINOSA D.O.
Internal Medicine
535 16TH ST, STE 750
DENVER, CO 80202
Denver County (303) 825-4646

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 Fall's NPI number?

The NPI number for Michael Fall is 1851548648. It was assigned to this individual provider in the NPPES registry on August 22, 2008.

Where is Michael Fall located?

Michael Fall practices at 535 16th St Ste 750, Denver, CO 80202. The listed phone number is (303) 825-4646.

What is Michael Fall's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Michael Fall enrolled in Medicare?

Yes. Michael Fall 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 Fall accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Michael Fall 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.

Is Michael Fall affiliated with any hospitals?

According to CMS data, Michael Fall is affiliated with St Luke's Regional Medical Center, St Luke's Nampa Medical Center, St Luke's Elmore Medical Center and St Luke's Mccall.

When was this NPI record last updated?

The NPPES record for Michael Fall was last updated on June 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.