Individual provider Active NPI

Connor Timothy Landusky

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1013688761
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007996 Issued in CO
Practice address
8101 E Lowry Blvd Ste 230
Denver, CO 80230-7195
Phone
(303) 344-9090
NPI assigned
Sep 22, 2021
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0007996 CO Primary

Addresses

Primary practice location

8101 E Lowry Blvd Ste 230
Denver, CO 80230-7195

Mailing address

8101 E Lowry Blvd Ste 230
Denver, CO 80230-7195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920001219 CO Practitioner - Physician Assistant 1254785546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11960 Lioness Way
Parker, CO 80134-5640

1411 S Potomac St
350 Coc Arapahoe Sports Medicine and Rehab
Aurora, CO 80012-4543
Phone (303) 695-6060

2430 Research Pkwy
Colorado Springs, CO 80920-1093

8101 E Lowry Blvd
Denver, CO 80230-7195
Phone (303) 344-9090

Merit-based Incentive Payment System (MIPS)

Final score
43.24 of 100Reported as group
Quality
73.53
Promoting interoperability
0
Improvement activities
0
Cost
70.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Centers of Colorado, LLC Physician Assistant CurrentSince Sep 1, 2023 Accepting new patients
Orthopedic Centers of Colorado, LLC Physician Assistant CurrentSince Sep 1, 2023 Accepting new patients

Locations

1411 S Potomac St
Ste 350
Aurora, CO 80012
Phone (303) 671-2134

8101 E Lowry Blvd
Ste 230
Denver, CO 80230
Phone (303) 962-3926

8101 E Lowry Blvd
Ste 120
Lowry, CO 80230
Phone (303) 806-1998

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1013688761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 E LOWRY BLVD STE 230",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 E LOWRY BLVD STE 230",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307195",
            "telephone_number": "303-344-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDUSKY",
        "first_name": "CONNOR",
        "middle_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-22",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.