STEFAN IVERSON (DO) – Surgery Physician, NPI 1053948646

STEFAN IVERSON (DO) is a healthcare provider. based in Lone tree, Colorado. specializing in GENERAL SURGERY. They hold the professional credentials DO. They hold a License No. 75732 (CO). The NPI Number for STEFAN IVERSON (DO) is 1053948646

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
STEFAN IVERSON (DO)
NPI
1053948646
Phone
(270) 562-5003
Address
10099 RIDGEGATE PKWY STE 200
Enumeration Date
24 March 2020
Last Update Date
12 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7195302477
Graduation Year
2020 (6 years ago)
PAC ID
6901393628
Group Practice PAC ID
3577451152
Professional Enrollment ID
I20251016000827
Address ID
CO812019627SA1000XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:6State licenses:1Digital endpointsOther names

756 GENERAL SURGERY in CO

Provider Addresses for STEFAN IVERSON (DO)

  • 10099 RIDGEGATE PKWY STE 200

    LONE TREE, CO 801245532

    Phone: (270) 562-5003

    Type: Mailing

  • 1101 PINON DR

    PONCHA SPRINGS, CO 812425084

    Phone:

    Type: Mailing

  • 1000 RUSH DR

    SALIDA, CO 812019627

    Phone: (719) 530-2000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251016000827IGeneral SurgeryCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80124)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577451152View full group profile
NameSpecialtyState
-CO
Qualified AudiologistCO
-CO
-CO
Nurse PractitionerCO
Orthopedic SurgeryCO
Family PracticeCO
Internal MedicineCO
Family PracticeCO
-CO

Reviews

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Frequently asked questions

What is the registry number for STEFAN IVERSON (DO)?
The registry entry for STEFAN IVERSON (DO) shows NPI 1053948646.
Is STEFAN IVERSON (DO)'s NPI status active today?
Active status means STEFAN IVERSON (DO)'s NPI record is not deactivated in the public file.
What type of care does STEFAN IVERSON (DO) provide?
STEFAN IVERSON (DO)'s profile centers on Surgery Physician. Clinical services aligned with this taxonomy classification.
What city is tied to STEFAN IVERSON (DO)?
The directory associates STEFAN IVERSON (DO) with Lone Tree, Colorado. Check all listed addresses for suites or satellite offices.
Who maintains STEFAN IVERSON (DO)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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