Active NPI
Rudy Haberzettl, MSPT
- Specialist
- Colorado Springs, CO
National Provider Identifier
1033326749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 6876
- Practice address
- 1855 Telstar Dr
Colorado Springs, CO 80920-1005 - Phone
- (719) 310-1741
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 6876 | CO | Primary |
Addresses
Primary practice location
1855 Telstar Dr
Colorado Springs, CO 80920-1005
Mailing address
6965 Amber Ridge Dr
Colorado Springs, CO 80922-2419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6876 | CO | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairgrounds Family Physicians PLLC | Past | Accepting new patients | |
| Duffy-Rath Physical Therapy, PC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Syracuse, NY
- NPI 1790889780
-
- Family Medicine Physician
- Manlius, NY
- NPI 1174690440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033326749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6965 AMBER RIDGE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809222419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1855 TELSTAR DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809201005",
"telephone_number": "719-310-1741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABERZETTL",
"first_name": "RUDY",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "6876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.