DR. GREGORY J CZUCZMAN (NPI# 1245411958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245411958 |
| Entity Type | Individual |
| Full Name | DR. GREGORY J CZUCZMAN |
| Credential | M.D. |
| Practice Address |
10700 E Geddes Ave Ste 200 Englewood CO 80112-3861 |
| Practice Telephone | (303) 761-9190 |
| Practice Fax Number | 7208744462 |
| Mailing Telephone | (303) 761-9190 |
| Mailing Fax Number | 7208744462 |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
29962 | NE | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
52616 | CO | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
239318 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | MEDICARE PIN | 561677YQN9 | 01 |
| CO | MEDICARE PIN | 561677ZLJ3 | 01 |
| CO | MEDICARE PIN | 561677ZNTB | 01 |
| KS | MEDICARE PIN | KA3249099 | 01 |
| NE | MEDICARE PIN | NA1214115 | 01 |
| CO | MEDICARE PIN | 561677YQ33 | 01 |
| KS | MEDICARE PIN | 111257108 | 01 |
| CO | 1245411958 | 05 | |
| CO | MEDICARE PIN | 561677YQPG | 01 |
| NE | MEDICARE PIN | NA1215116 | 01 |
| NE | MEDICARE PIN | NA2517094 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 55 Fruit St, Fnd-216, Boston, MA 021142621 | 8569127233 |
| Street Address |
10700 E GEDDES AVE STE 200 |
| City | ENGLEWOOD |
| State | CO |
| Zip Code | 80112-3861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972586998 | Ross A Goldstein | Radiology | 10700 E Geddes Ave Ste 200, Englewood, CO 80112-3861 | 2005-11-23 |
| 1366858177 | Jessica Rae Cox | Radiology | 10700 E Geddes Ave Ste 200, Englewood, CO 80112-3861 | 2014-07-01 |
| 1497188569 | Tamara P Reeves-sandoval | Nurse Practitioner | 10700 E Geddes Ave Ste 200, Englewood, CO 80112-3861 | 2013-08-13 |
| 1033558101 | Tessa Suzanne Henderson | Nurse Practitioner | 10700 E Geddes Ave Ste 200, Englewood, CO 80112-3861 | 2013-06-21 |
| 1104269943 | Mustafa Mahmoud Haddad | Radiology | 10700 E Geddes Ave Ste 200, Englewood, CO 80112 | 2013-04-11 |
| 1679810337 | Carol B. Johnston | Nurse Practitioner | 10700 E Geddes Ave Ste 200, Englewood, CO 80112-3861 | 2013-01-14 |
| 1306100888 | Kelly Christine Borden | Radiology | 10700 E Geddes Ave Ste 200, Englewood, CO 80112-3861 | 2012-06-28 |
| 1780947531 | Nishant Anilkumar Patel | Radiology | 10700 E Geddes Ave Ste 200, Englewood, CO 80112 | 2012-06-18 |
| 1922385020 | Jacqueline Denise Fearon | Registered Nurse | 10700 E Geddes Ave Ste 200, Englewood, CO 80112-3861 | 2011-11-03 |
| 1699060582 | Cosette M. Stahl | Radiology | 10700 E Geddes Ave Ste 200, Englewood, CO 80112-3861 | 2011-06-18 |
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|---|---|---|---|---|
| 1750921177 | Natalie Jo Stevenson | Social Worker | 12835 E Arapahoe Rd., Tower 2, Suite 400, Centennial, CO 80112 | 2020-01-14 |
| 1033757109 | Sauder Psychology, Inc | Psychologist | 9085 E. Mineral Cir, Suite 235, Centennial, CO 80112 | 2019-12-19 |
| 1588213581 | Myappstorebiz | Special Hospital | 13033 E Adam Aircraft Circle B 53, Englewood, CO 80112 | 2019-09-11 |
| 1669930319 | Linked To Craig 501c3 | Dentist | 9085 E. Mineral Circle, Suite 350, Centennial, CO 80112 | 2019-03-12 |
| 1528538311 | Cherish Mitchell | Behavior Technician | 12660 E Briarwood Ave, Suite 207, Centennial, CO 80112 | 2018-12-05 |
| 1144706920 | Margaret Mary Froehlke | Homemaker | 6278 E Jamison Dr, Centennial, CO 80112 | 2018-07-16 |
| 1376038240 | Elizabeth Ann Dickason | Physician Assistant | 9094 East Mineral Avenue, #100, Englewood, CO 80112 | 2018-06-24 |
| 1770075467 | Dry Creek Surgery Center, LLC | Clinic/Center | 125 Inverness Dr E Ste 150, Englewood, CO 80112 | 2018-05-30 |
| 1639669476 | Uchealth Ambulatory Surgery Centers | Clinic/Center | 175 Inverness Drive West, Englewood, CO 80112 | 2018-05-17 |
| 1427545227 | Patterns Behavioral Services Colorado Inc | Assistant Behavior Analyst | 7600 E Arapahoe Rd Ste 211, Centennial, CO 80112 | 2018-04-17 |
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| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417104399 | Sean Enis | Radiology | 189 Lyman Pl, Englewood, NJ 07631-3609 | 2008-08-22 |
| 1609928126 | Bergen Imaging Ctr Pa | Radiology | 180 North Dean St, Englewood, NJ 07631 | 2007-01-17 |
| 1982641916 | Bao C Nguyen | Radiology | 9780 Mt Pyramid Ct, Suite 160, Englewood, CO 80112-7054 | 2006-05-31 |
| 1316926272 | Allison Luanne Summers | Radiology | 383 Inverness Pkwy, Suite 280, Englewood, CO 80112-5865 | 2006-01-10 |
| 1821073180 | Joel A. Budin | Radiology | 355 Broad Ave, Englewood, NJ 07631-4348 | 2005-12-09 |
| 1922083401 | Phillip Gunther | Radiology | 10700 E Geddes Ave, Ste 200, Englewood, CO 80112-3800 | 2005-12-07 |
| 1487640462 | Dulcy E Wolverton | Radiology | 10700 E. Geddes Ave, Attn: Credentialing, Englewood, CO 80112-3681 | 2005-09-23 |
| 1518963214 | South Denver Integrated Imaging LLC | Radiology | 14251 E Fremont Ave, Englewood, CO 80112-4443 | 2005-06-27 |
| 1356345680 | Benjamin E Kassanoff | Radiology | 501 E Hampden Ave, Englewood, CO 80113-2702 | 2005-05-31 |
| 1922556083 | Ugorji Radiology Consultants, LLC | Radiology | 7550 S Blackhawk St, #6-208, Englewood, CO 80112-4068 | 2016-09-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.