DR. BRIAN P GRADISEK (NPI# 1700178092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700178092 |
| Entity Type | Individual |
| Full Name | DR. BRIAN P GRADISEK |
| Credential | D.P.M. |
| Practice Address |
1400 28th St Ste 2 Boulder CO 80303-1096 |
| Practice Telephone | 3034492000 |
| Practice Fax Number | 3034499475 |
| Mailing Telephone | 3034492000 |
| Mailing Fax Number | 3034499475 |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2016-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 016005597 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0000766 | CO | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016005597 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 016005597 | 05 |
| Street Address |
1400 28TH ST STE 2 |
| City | BOULDER |
| State | CO |
| Zip Code | 80303-1096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154890291 | Brian P Gradisek Dpm Pllc | Podiatrist | 1400 28th St Ste 2, Boulder, CO 80303-1096 | 2018-11-19 |
| 1770879413 | Nicole Megan Roth | Podiatrist | 1400 28th St Ste 2, Boulder, CO 80303-1096 | 2011-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821583725 | Ariel Meyers | Physical Therapist | Frasier Meadows Retirement Community Dept. of Rehab, 350 Ponca Place, Boulder, CO 80303 | 2018-06-25 |
| 1831683838 | Sandra Ramsey | Occupational Therapist | 350 Ponca, Boulder, CO 80303 | 2018-06-22 |
| 1770085243 | Laura Michelle Boucher | Physical Medicine & Rehabilitation | 5387 Manhattan Cir, Ste 200, Boulder, CO 80303 | 2018-03-01 |
| 1396255568 | Colorado Sports Chiropractic | Chiropractor | 1440 28th St Ste 2, Boulder, CO 80303 | 2017-10-02 |
| 1932618782 | Michele Adrienne Packard | Psychologist | 4410 Arapahoe Suite 140, Boulder, CO 80303 | 2017-09-25 |
| 1134505290 | Bili Blanket Baby, LLC | Durable Medical Equipment & Medical Supplies | 4450 Arapahoe Ave, Suite 100, Boulder, CO 80303 | 2015-07-30 |
| 1710378146 | Jonathan Gardiner Lears | Counselor | 5600 Arapahoe Ave, Suite 102, Boulder, CO 80303 | 2015-02-06 |
| 1114316965 | Northstar Transitions | Substance Abuse Rehabilitation Facility | 75 Manhattan Dr., Suites 110 and 208 Northstar Transitions, Boulder, CO 80303 | 2015-01-16 |
| 1902226434 | Integrated Dermatology of Boulder, Pllc | Dermatology | 2935 Baseline Road, Suite 201, Boulder, CO 80303 | 2014-04-23 |
| 1396160081 | Melissa Rupert | Physical Therapist | 975 Waite Drive, Boulder, CO 80303 | 2014-03-04 |
| Find all providers in zip 80303 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811903446 | Zak H Weis | Podiatrist | 10 Benthaven Pl, Boulder, CO 80305-6252 | 2006-08-01 |
| 1730173519 | Robert Alan Jelinek | Podiatrist | 350 Broadway St, #208, Boulder, CO 80305-3343 | 2005-09-07 |
| 1770879413 | Nicole Megan Roth | Podiatrist | 1400 28th St Ste 2, Boulder, CO 80303-1096 | 2011-06-21 |
| 1487762761 | Columbine Foot & Ankle Center P C | Podiatrist | 350 Broadway, Ste 208, Boulder, CO 80305 | 2006-08-28 |
| 1790746170 | Christina Alice Weber | Podiatrist | 3000 Center Green Dr, Suite 210, Boulder, CO 80301-2364 | 2006-03-28 |
| 1891756250 | Yvonne Bridgett Weber | Podiatrist | 3000 Center Green Dr, Suite 210, Boulder, CO 80301-2364 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558975771 | David Erik Ouderkirk Dpm PC | Podiatrist | 11310 N Huron Street, Suite 20, Northglenn, CO 80234-3090 | 2020-09-04 |
| 1073126173 | David Erik Ouderkirk Dpm PC | Podiatrist | 4185 E. Wildcat Reserve Pkwy, Suite 200, Highlands Ranch, CO 80126-6803 | 2020-08-28 |
| 1225646979 | New West Physicians, P.C. | Podiatrist | 1536 Cole Blvd # 4-250, Lakewood, CO 80401-3413 | 2020-07-20 |
| 1396207296 | Emily Marie Opp | Podiatrist | 25775 Road T, Dolores, CO 81323-9202 | 2019-04-01 |
| 1578061420 | Colorado Foot and Ankle Research Institute | Podiatrist | 3438 Federal Blvd, Denver, CO 80211 | 2018-01-25 |
| 1538677976 | South Denver Podiatry LLC | Podiatrist | 7780 S Broadway Ste 190, Littleton, CO 80122-2641 | 2018-01-19 |
| 1386094142 | Phillip Savage | Podiatrist | 1421 S Potomac St Ste 120, Aurora, CO 80012-4511 | 2016-06-13 |
| 1427450014 | Eastern Colorado Podiatry LLC | Podiatrist | 16350 E Arapahoe Rd, Suite 108, Foxfield, CO 80016-1557 | 2014-09-25 |
| 1003225160 | Alfred Kwon | Podiatrist | 10268 W Centennial Rd Ste 104, Littleton, CO 80127-6423 | 2014-08-03 |
| 1639580293 | Meredith Rawa | Podiatrist | 1301 Riverside Ave Ste 1, Fort Collins, CO 80524 | 2014-05-16 |
| 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.