MOUNTAIN BLUE CANCER CARE CENTER PC (NPI# 1699009084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699009084 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN BLUE CANCER CARE CENTER PC |
| Practice Address |
400 Indiana St #270 Golden CO 80401-5027 |
| Mailing Address |
400 Indiana St #270 Goldon CO 80401-5027 |
| Practice Telephone | 3039537400 |
| Practice Fax Number | 3039537401 |
| Mailing Telephone | 3039537400 |
| Mailing Fax Number | 3039537401 |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2017-11-09 |
| Authorized Official Name | DR. SAMIR E WITTA (OWNER) |
| Authorized Official Telephone | 3039537400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
39764 | CO | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
CO39762 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 82076529 | 05 |
| Street Address |
400 INDIANA ST #270 |
| City | GOLDEN |
| State | CO |
| Zip Code | 80401-5027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053303115 | Kathleen Yumi Sawada | Dermatology | 400 Indiana St, Suite 390, Golden, CO 80401-5027 | 2005-08-16 |
| 1003414871 | Jessica Chu | Physical Therapist | 400 Indiana St, Golden, CO 80401-5027 | 2020-10-14 |
| 1710412002 | Wellue Clinic | Clinic/Center | 400 Indiana St, Suite 320, Golden, CO 80401-5027 | 2017-04-25 |
| 1316486624 | Southern Colorado Physical Medicine | Specialist | 400 Indiana St, Suite 320, Golden, CO 80401-5027 | 2017-02-20 |
| 1497293849 | Mtn Physical Therapy | Clinic/Center | 400 Indiana St, Ste. 320, Golden, CO 80401-5027 | 2017-02-06 |
| 1548633753 | Fresh Tracks Physical Therapy LLC | Clinic/Center | 400 Indiana St, Suite 320, Golden, CO 80401-5027 | 2015-11-10 |
| 1063803823 | Wade R. Hirschman Dds PC | Clinic/Center | 400 Indiana St, Suite 370, Golden, CO 80401-5027 | 2015-02-13 |
| 1962801571 | Stephen T Huang Md Pllc | Clinic/Center | 400 Indiana St, Suite 390, Golden, CO 80401-5027 | 2014-08-19 |
| 1417364233 | Comprehensive Physical Rehab Specialists | Chiropractor | 400 Indiana St, Suite 320, Golden, CO 80401-5027 | 2014-07-14 |
| 1528472297 | Mark Kuchar | Chiropractor | 400 Indiana St, Suite 320, Golden, CO 80401-5027 | 2014-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315152 | Ruth Lucia Settak | Social Worker | 17301 W. Colfax Ave., Ste 200, Golden, CO 80401 | 2020-10-28 |
| 1811457088 | Evening Elegance LLC | Prosthetic/Orthotic Supplier | 14500 W Colfax Ave Unit 246, Lakewood, CO 80401 | 2019-03-22 |
| 1255853826 | Angela Kathryn Brickman | Behavior Technician | 714 Ridgeside Drive, Golden, CO 80401 | 2017-07-14 |
| 1710408240 | Catherine Camacho | Psychologist | 913 Arapahoe St, Golden, CO 80401 | 2017-07-06 |
| 1710420492 | Colorado Complete Urgent Care Physicians LLC | Clinic/Center | 17101 S Golden Rd., Golden, CO 80401 | 2016-11-29 |
| 1366991051 | Britta Marie Olson | Physical Therapist | 600 Golden Ridge Rd, Suite 130, Golden, CO 80401 | 2016-09-23 |
| 1003284209 | Maria Alta Mcvey | Dental Hygienist | 2305 Jackson St., Golden, CO 80401 | 2015-09-04 |
| 1548644479 | Christine Rodriguez | Dental Hygienist | 2305 Jackson Street, Golden, CO 80401 | 2015-07-09 |
| 1508285776 | Colorado Pain Practice, Pllc | Anesthesiology | 755 Heritage Road, Suite 100, Golden, CO 80401 | 2014-04-15 |
| 1942644844 | Golden Kids Dental | Dentist | 2421 Ford St., Golden, CO 80401 | 2013-04-22 |
| Find all providers in zip 80401 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013991678 | Samir Ezzeldin Witta | Internal Medicine | 400 Indiana St, Suite 270, Golden, CO 80401-5027 | 2005-12-06 |
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| 1285242636 | Rocky Mountain Cancer Centers LLP | Internal Medicine | 10107 Ridgegate Pkwy Ste 300, Lone Tree, CO 80124-5642 | 2020-07-21 |
| 1356965529 | Platte Valley Medical Group, LLC | Internal Medicine | 1606 Prairie Center Pkwy Ste 270, Brighton, CO 80601-4005 | 2020-06-03 |
| 1457980617 | Poudre Valley Medical Group, LLC | Internal Medicine | 4050 Briargate Pkwy Ste C1100, Colorado Springs, CO 80920-7815 | 2020-04-08 |
| 1407351950 | University Physicians Incorporated | Internal Medicine | 13199 E Montview Blvd Ste 100, Aurora, CO 80045-7202 | 2018-03-27 |
| 1114439924 | Cancer Centers of Colorado, LLC | Internal Medicine | 1601 Lowell Blvd Ste 150, Denver, CO 80204-1545 | 2017-11-02 |
| 1760814644 | Cccric LLC | Internal Medicine | 799 E Hampden Ave Ste 500, Englewood, CO 80113-2777 | 2013-08-02 |
| 1336482769 | Tejas Patil | Internal Medicine | 12801 E 17th Ave Fl 81018, Aurora, CO 80045-2530 | 2013-04-04 |
| 1851667596 | Michelle A Levy | Internal Medicine | 1800 N Williams St Ste 200, Denver, CO 80218-1237 | 2012-03-27 |
| 1790818425 | Western Hematology Oncology Associates, P.C. | Internal Medicine | 34 Van Gordon St, Suite 160, Lakewood, CO 80228-1705 | 2007-03-13 |
| Find all providers with the same taxonomy | ||||
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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.