Mark D Guadagnoli, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

29590 Issued in CO

Practice address

2500 Rocky Mountain Ave
Ste 100
Loveland, CO 80538-9004

Phone

(970) 624-1800

Fax

(970) 624-1891

NPI assigned

Oct 11, 2005

Last updated

Dec 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mguadagnoli27709@direct.crmcwy.org

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.

• Poudre Valley Health Care Inc.

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1760492714
  NPD
• Poudre Valley Health Care,Inc

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1891837738
  NPD (past)
• Cheyenne Regional Physicians Group, LLC

  • Pediatrics Physician
  • Cheyenne, WY
  • NPI 1629737259
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1043208259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-624-1800",
            "fax_number": "970-624-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE",
            "address_2": "STE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-624-1800",
            "fax_number": "970-624-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADAGNOLI",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CO",
            "license": "29590",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WY",
            "license": "5495A",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CO",
            "license": "29590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01295906",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043208259",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00970371",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111738600",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mguadagnoli27709@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mguadagnoli27709@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph A Grossman, MA
• Narina Grove, MD
• Samantha Ashley Grubb, M.S. SLP-CCC
• Swaniee Grubb, PHARMD
• GSD Initiative LLC (Optimal Home Care Loveland)
• Helen Guarino
• Mildred Guerin, PTA
• Erika Leigh Guider, PA-C
• Ben Guizar, LPC, MA
• Meng Guo, M.D.

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Loveland, CO
• Providers in Loveland, CO by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.