Philip B Dattilo (NPI# 1245452994, PAC ID# 3072664960) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL CARDIOLOGY.
| Nation Provider ID (NPI) | 1245452994 |
| PAC ID by PECOS | 3072664960 |
| Professional Enrollment ID | I20090707000184 |
| Full Name | Philip B Dattilo |
| Organization Legal Name | POUDRE VALLEY MEDICAL GROUP LLC |
| Address |
2121 E Harmony Rd Unit 100 Uchmg Cardiology Fort Collins Fort Collins CO 80528-3401 |
| Phone Number | 9702211000 |
| Gender | M |
| Medical School | ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY |
| Graduation Year | 2001 |
| Primary Specialty | INTERVENTIONAL CARDIOLOGY |
| Secondary Specialties | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Group Practice PAC ID | 9638208549 |
| Number of Group Practice Members | 1070 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 060119 | MEDICAL CENTER OF THE ROCKIES |
| 060010 | POUDRE VALLEY HOSPITAL |
| 060131 | |
| 060128 | LONGS PEAK HOSPITAL |
| 280061 | REGIONAL WEST MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 5050 Powerhouse Rd, Cheyenne, WY 82009-4892 | 3076341311 | POUDRE VALLEY MEDICAL GROUP LLC |
| 2121 E Harmony Rd Unit, 100 Uchmg Cardiology Fort Collins, Fort Collins, CO 80528-3401 | 9702211000 | POUDRE VALLEY MEDICAL GROUP LLC |
| 2 W 42nd St, Suite 2200, Scottsbluff, NE 69361-4610 | 3086302626 | POUDRE VALLEY MEDICAL GROUP LLC |
| Organization Legal Name | POUDRE VALLEY MEDICAL GROUP LLC |
| Physicians | 1041 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Henry Monkowski | Infectious Disease | Poudre Valley Medical Group LLC | 1625 Foxtrail Dr, Suite 200, Loveland, CO 80538-9089 |
| Nataliia A Baker | Family Medicine | Poudre Valley Medical Group LLC | 1455 Main St, Suite 100, Windsor, CO 80550-5559 |
| Stephanie Pivik Mager | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 1715 61st Ave, Greeley, CO 80634-7989 |
| Kerri Alicia Madden | Physician Assistant | Poudre Valley Medical Group LLC | 4404 Barranca Ln, Unit 101, Castle Rock, CO 80104-7432 |
| Alicia Vandersluis | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 6705 Rangewood Dr, Colorado Springs, CO 80918-7300 |
| Megan Leigh Kelly | Clinical Social Worker | Poudre Valley Medical Group LLC | 11820 Destination Dr, Broomfield, CO 80021-2518 |
| Mark Oscar Robinson | Family Medicine | Poudre Valley Medical Group LLC | 15854 Jackson Creek Pkwy, Unit 120, Monument, CO 80132-8663 |
| Kimberly Atiyeh | Otolaryngology | Poudre Valley Medical Group LLC | 16222 W Us Hwy 24 210, Uchmg Woodland Park Outreach, Woodland Park, CO 80863-8763 |
| Adam Lee Kilkenney | Family Medicine | Poudre Valley Medical Group LLC | 5265 N Academy Blvd, Suite 1800, Colorado Springs, CO 80918-4061 |
| Marlesa Renee Moore | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 1015 E Pikes Peak Ave, Suite 100, Colorado Springs, CO 80903-5700 |
| Street Address |
2121 E HARMONY RD UNIT 100 UCHMG CARDIOLOGY FORT COLLINS |
| City | FORT COLLINS |
| State | CO |
| Zip | 80528-3401 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Diana Michele Breyer | Critical Care (intensivists) | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 300 Uchmg Pulmonology Fort Collins, Fort Collins, CO 80528-3403 |
| Diana C Medgyesy | Hematology/oncology | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 170 Uchmg Cancer Care and Hem Fc, Fort Collins, CO 80528-3413 |
| Meriam P Izon | Endocrinology | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 230 Uchmg Endocrinology/rheumatology, Fort Collins, CO 80528-3401 |
| Jennifer M Hendrick | Internal Medicine | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, Fort Collins, CO 80528-3401 |
| Arthur K Liu | Radiation Oncology | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 160 Uchmg Radiation Oncology, Fort Collins, CO 80528-3413 |
| Miho T Scott | Hematology/oncology | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 170 Uchmg Cancer Care and Hem Fc, Fort Collins, CO 80528-3413 |
| Thomas T Heacock | Pulmonary Disease | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 300 Uchmg Pulmonology Fort Collins, Fort Collins, CO 80528-3403 |
| Joshua W Burrow | Physician Assistant | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, Fort Collins, CO 80528-3413 |
| Carlos R Vassaux | Critical Care (intensivists) | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 300 Uchmg Pulmonology Fort Collins, Fort Collins, CO 80528-3403 |
| Madeline Vaughn | Physician Assistant | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, Fort Collins, CO 80528-3413 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christine M Higginson | Chiropractic | 5026 Brookfield Dr, Unit C, Fort Collins, CO 80528-3181 | |
| Bruce Michael Smith | Otolaryngology | Ear Nose and Throat Associates of Northern Colorado PC | 2121 E Harmony Rd, Suite 350, Fort Collins, CO 80528-3400 |
| Daniel Eugene Ostergren | Qualified Audiologist | Ear Nose and Throat Associates of Northern Colorado PC | 2121 E Harmony Rd, Suite 350, Fort Collins, CO 80528-3400 |
| Meghan M.w. Abraham | Audiologist | Ear Nose and Throat Associates of Northern Colorado PC | 2121 E Harmony Rd, Suite 350, Fort Collins, CO 80528-3400 |
| Jill M Olson | Neurology | Advanced Neurology of Colorado LLC | 2121 E Harmony Rd, Unit 180, Fort Collins, CO 80528-3401 |
| Meghan Reusser | Nurse Practitioner | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 230 Uchmg Endocrinology/rheumatology, Fort Collins, CO 80528-3401 |
| Robert Kiser | Cardiac Electrophysiology | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 100 Uchmg Cardiology Fort Collins, Fort Collins, CO 80528-3401 |
| Eric Riles | Cardiac Electrophysiology | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 100 Uchmg Cardiology Fort Collins, Fort Collins, CO 80528-3401 |
| Andrew M Norris | Ophthalmology | 2121 E Harmony Rd, Unit 190, Fort Collins, CO 80528-3401 | |
| Mohamed Zaki Ahmed Refaat | Cardiovascular Disease (cardiology) | Poudre Valley Medical Group LLC | 2121 E Harmony Rd Unit, 100 Uchmg Cardiology Fort Collins, Fort Collins, CO 80528-3401 |
| Find all physicians in zip 80528 | |||
| City | FORT COLLINS |
| Zip Code | 80528 |
| Specialty | INTERVENTIONAL CARDIOLOGY |
| City + Specialty | FORT COLLINS + INTERVENTIONAL CARDIOLOGY |
Please comment or provide details below to improve the information on Philip B Dattilo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.