DR. MARK DAVID EWALT (NPI# 1497998512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497998512 |
| Entity Type | Individual |
| Full Name | DR. MARK DAVID EWALT |
| Credential | M.D. |
| Practice Address |
12605 E 16th Ave Aurora CO 80045-2545 |
| Mailing Address |
Po Box 110429 Aurora CO 80042-0429 |
| Practice Telephone | 7208480000 |
| Mailing Telephone | (303) 493-7000 |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
DR.0058760 | CO | Allopathic & Osteopathic Physicians |
| N | 207ZH0000X |
Pathology Specialization: Hematology |
DR.0058760 | CO | Allopathic & Osteopathic Physicians |
| N | 207ZH0000X |
Pathology Specialization: Hematology |
A121762 | CA | Allopathic & Osteopathic Physicians |
| Y | 207ZP0007X |
Pathology Specialization: Molecular Genetic Pathology |
DR.0058760 | CO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8700 Beverly Blvd, Spt Room 4703, West Hollywood, CA 900481804 | 3104234551 |
| Street Address |
12605 E 16TH AVE |
| City | AURORA |
| State | CO |
| Zip Code | 80045-2545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556694 | Mark Armin Levine | Internal Medicine | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2005-05-23 |
| 1962001719 | Poudre Valley Medical Group, LLC | Social Worker | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-10-22 |
| 1811595473 | Jason Hayes | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-10-15 |
| 1710584560 | Alleson Bayer | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-10-05 |
| 1316554009 | Lisa Najera | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-09-26 |
| 1699382705 | James Lloyd Martin Jr. | Pharmacy | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-09-23 |
| 1740808575 | Beth Lee Smilkstein | Physician Assistant | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-07-08 |
| 1780200907 | Amanda Marie Miller-sarmento | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-06-23 |
| 1558987909 | Heather Ann Sutton | Counselor | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-06-22 |
| 1982220349 | Rocco James Miele | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942817408 | Salwa Mourtada Bamba | Nurse Practitioner | University of Colorado Medicine, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-09-29 |
| 1114545233 | Chun Cheong Tsui | Student in an Organized Health Care Education/Training Program | 12801 E. 17th Avenue, Ms 8117, Aurora, CO 80045 | 2020-07-07 |
| 1487278719 | James Charles Tuka IIi | Social Worker | 1700 North Wheeling, Aurora, CO 80045 | 2020-06-02 |
| 1427677806 | Justin Yu | Student in an Organized Health Care Education/Training Program | 12631 E. 17th Ave. Ms B205, Aurora, CO 80045 | 2020-04-15 |
| 1558980011 | Erik Von Polsdofer | Student in an Organized Health Care Education/Training Program | Academic Office 1; Department of Pathology, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-04-14 |
| 1831718568 | Luke Porter Bacon | Student in an Organized Health Care Education/Training Program | 3001 East 17th Place, Aurora, CO 80045 | 2020-04-13 |
| 1366061368 | Hilary Novatt | Student in an Organized Health Care Education/Training Program | 12631 E 17th Ave, B198-6, Room 4007, Aurora, CO 80045 | 2020-04-10 |
| 1376195362 | Katie Tuck | Pharmacist | 1700 North Wheeling Street (119), Fs-111o, Aurora, CO 80045 | 2019-07-10 |
| 1518529130 | Ronak Kamal Kapadia | Student in an Organized Health Care Education/Training Program | 12700 E. 19th Ave, Ms B182 Rm 5104, Aurora, CO 80045 | 2019-07-03 |
| 1245898253 | Rasha Elbadry Ahmed | Student in an Organized Health Care Education/Training Program | Childrens Hospital Colorado Pediatric Neurosurgery, 13123e. 16th Ave, B330, Aurora, CO 80045 | 2019-06-04 |
| Find all providers in zip 80045 | ||||
| Taxonomy Code | 207ZP0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Molecular Genetic Pathology |
| A molecular genetic pathologist is expert in the principles, theory and technologies of molecular biology and molecular genetics. This expertise is used to make or confirm diagnoses of Mendelian genetic disorders, disorders of human development, infectious diseases and malignancies, and to assess the natural history of those disorders. A molecular genetic pathologist provides information about gene structure, function and alteration and applies laboratory techniques for diagnosis, treatment and prognosis for individuals with related disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate for MGG was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598907974 | Amanda Lauren Treece | Pathology | 13123 E 16th Ave, B120, Aurora, CO 80045-7106 | 2009-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629613534 | Healix Pathology, LLP | Pathology | 13635 E 104th Ave Unit 400, Commerce City, CO 80022-8414 | 2019-11-14 |
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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.