Individual provider Active NPI

Andrew Fedorowicz, MD

  • Internal Medicine Physician
  • Greenwood Village, CO
National Provider Identifier
1013989342
Registry record updated Dec 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36699 Issued in CO
Practice address
5351 S Roslyn St
Suite 102
Greenwood Village, CO 80111-2128
Phone
(720) 507-7051
Fax
(720) 507-7052
NPI assigned
Feb 2, 2006
Last updated
Dec 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36699 CO Primary

Addresses

Primary practice location

5351 S Roslyn St
Suite 102
Greenwood Village, CO 80111-2128

Mailing address

5351 S. Roslyn St.
Suite 102
Englewood, CO 80111
Phone (720) 507-7051

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180725002070 CO Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1850331042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36699COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Gastroenterology Prof LLC PastSince Feb 19, 2024 Accepting new patients
Denver Digestive Health Specialists Inc PastSince Jan 2, 1998 Accepting new patients
Sound Hospitalists of Centura, PC Internal Medicine Past Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Organizations & group practices 4

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1013989342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5351 S. ROSLYN ST.",
            "address_2": "SUITE 102",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "80111",
            "telephone_number": "720-507-7051",
            "fax_number": "720-507-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5351 S ROSLYN ST",
            "address_2": "SUITE 102",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112128",
            "telephone_number": "720-507-7051",
            "fax_number": "720-507-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOROWICZ",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "36699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

Verify at the official NPI Registry.