DR. GRACE C FAN MD
NPI 1871598276
Pediatrics - Pediatric Emergency Medicine in Longmont, CO

Q: What is Grace Fan's NPI number?

The NPI number for Grace Fan is 1871598276. It was assigned to this individual provider in the NPPES registry on June 14, 2005.

Q: What is Grace Fan's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for Grace Fan was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since June 14, 2005PECOS Enrolled

1925 W MOUNTAIN VIEW AVE, LONGMONT, CO 80501(303) 776-1234(720) 494-3107 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Feb 27, 2018 (2 updates tracked since 2018).

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About Dr. Grace C Fan Md NPPES

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

DR. GRACE C FAN MD (NPI 1871598276) is an individual pediatric emergency medicine provider in Longmont, Colorado, licensed in Colorado (DR.0030740) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS and maintains a secondary practice location in Longmont.

NPPES Registry Identity

NPI1871598276

Entity TypeIndividualFemale

Primary Taxonomy2080P0204X

Provider Legal NameDR. GRACE C FANCredential: MD

Location Address1925 W MOUNTAIN VIEW AVELongmont, CO 80501-3128

Mailing AddressPo Box 110429Aurora, CO 80042-0429 · (303) 493-7000

Phone(303) 776-1234

Fax(720) 494-3107

Sole ProprietorNo

Enumeration DateJune 14, 2005

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1871598276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

License✔ Licensed in CO · DR.0030740

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedPediatricsTaxonomy 208000000X · License 30740 (CO)

1925 W MOUNTAIN VIEW AVE, Longmont, CO 80501

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Secondary Practice Location 1

Location 11925 W Mountain View AveLongmont, CO 80501-3128 · Phone (303) 776-1234 · Fax (720) 494-3107

Other Identifiers 1

Medicaid01307404CO

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Grace C Fan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DR. LYLE M PFEIFER MD

Family Medicine