Provider Demographics
NPI:1255388955
Name:STROTE, JUSTIN ARI-BENJAMIN (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ARI-BENJAMIN
Last Name:STROTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8702
Mailing Address - Country:US
Mailing Address - Phone:970-221-1000
Mailing Address - Fax:970-297-6860
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3400
Practice Address - Country:US
Practice Address - Phone:970-221-1000
Practice Address - Fax:970-297-6860
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042626207R00000X, 207RC0000X
CO46491207RC0000X
CODR.0046491207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00970360OtherMEDICARE RAILROAD
WY125902400Medicaid
NE840769717Medicaid
CO93253753Medicaid
NEP01084740OtherMEDICARE RR
WAI36097Medicare UPIN
COCO300202Medicare PIN
COCOA105061Medicare PIN
COP00970360OtherMEDICARE RAILROAD
NEP01084740OtherMEDICARE RR