LYSSA N CHACKO


Address: 1055 Clermont St # Ms 111e, Denver, CO 80220-3808
Phone: 3033998020

LYSSA N CHACKO (NPI# 1629115993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629115993
Entity Type Individual
Full Name LYSSA N CHACKO
Credential MD
Practice Address 1055 Clermont St # Ms 111e
Denver
CO 80220-3808
Practice Telephone 3033998020
Mailing Telephone 3033998020
Enumeration Date 2007-01-30
Last Update Date 2010-03-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RG0100X Internal Medicine
Specialization: Gastroenterology
MD431382 PA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PA 1019975240001 05

Office Location

Street Address 1055 CLERMONT ST # MS 111E
City DENVER
State CO
Zip Code 80220-3808

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Taxonomy Information

Taxonomy Code 207RG0100X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Gastroenterology

Taxonomy Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184967598 Vihang Vijaykumar Patel Internal Medicine 2335 S Downing St Ste 360, Denver, CO 80210-5809 2013-04-03
1730488099 Stephen M New Internal Medicine 4500 E 9th Ave Ste 720s, Denver, CO 80220-3926 2011-03-24
1265690374 Jennifer Lynne Goldman Moss Internal Medicine 4500 E 9th Ave Ste 560s, Denver, CO 80220-3934 2008-05-26
1144407164 Mile High Gastroenterology,p.c. Internal Medicine 2005 Franklin St Ste 210, Denver, CO 80205-5403 2008-01-22
1871548685 Andrew Mallory Internal Medicine 2005 Franklin Street #280, Denver, CO 80205 2006-05-23
1669423430 Clark C Kulig Internal Medicine 1719 E 19th Ave # 5050, Denver, CO 80218-1235 2006-05-15
1366491367 Aaron Joseph Burrows Internal Medicine 4545 E 9th Ave Ste 440, Denver, CO 80220-3914 2006-05-08
1700495579 Poudre Valley Medical Group, LLC Internal Medicine 100 Cook Street, Suite 312, Denver, CO 80206 2020-07-28
1891322756 Healthone Clinic Services Medical Specialties LLC Internal Medicine 4700 Hale Pkwy Ste 150, Denver, CO 80220-4054 2020-03-23
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City DENVER
Zip Code 80220

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Dataset Information

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.

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