Active NPI
Pantelis Hadjizacharia, M.D.
- Vascular Surgery Physician
- Pueblo, CO
National Provider Identifier
1043472400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- CDRH.0054955
- Practice address
- 1401 Court St
Pueblo, CO 81003-2715 - Phone
- (719) 562-2300
- NPI assigned
- Jun 26, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | R70524 | AZ | |
| Cardiovascular Disease Physician | 207RC0000X | DR.0054955 | CO | |
| Vascular Surgery Physician | 2086S0129X | 48372 | AZ | |
| Vascular Surgery Physician | 2086S0129X | CDRH.0054955 | CO | Primary |
Addresses
Primary practice location
1401 Court St
Pueblo, CO 81003-2715
Mailing address
PO Box 560825
Denver, CO 80256-0825
Phone (719) 595-7580
Other practice location 1
2270 S Ridgeview Dr Ste 201
Yuma, AZ 85364-8880
Phone (928) 344-5055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76507254 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, FL, AZ, MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 Erie Pkwy
Suite 201G
Erie, CO 80516-4072
Phone (303) 443-2123
2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000
3000 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 454-2171
Hospital & facility affiliations
- Yuma Regional Medical Center
- Great Falls Clinic Hospital
- Boulder Community Health
- Benefis Hospitals Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 21 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R70524 | AZ | MD | Surgery Physician |
| 48372 | AZ | MD | Vascular Surgery Physician |
| CDRH.0054955 | CO | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Yuma Regional Medical Center | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Surgery | Current | Accepting new patients |
| University of Florida Jacksonville Physicians Inc | Surgery | Current | Accepting new patients |
| Poudre Valley Medical Group, LLC | Surgery | Current | Accepting new patients |
| Yuma Regional Medical Center | Current | Accepting new patients | |
| Parkview Medical Center, Inc. | Past | Accepting new patients |
Locations
2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100
2270 S Ridgeview Dr
Ste 201
Yuma, AZ 85364
Phone (928) 344-5055
4743 Arapahoe Ave
Ste 100
Boulder, CO 80303
Phone (303) 415-4599
1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
101 Erie Pkwy
Ste 201G
Erie, CO 80516
Phone (303) 415-4599
1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760
1401 Court St
Pueblo, CO 81003
Phone (719) 562-2300
1600 N Grand Ave
Ste 500
Pueblo, CO 81003
Phone (719) 545-0663
655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680
Networks
- CO HMO
- devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
- CO HMO C-SNP
- CO HMO D-SNP
Interoperability endpoints
- phadjizacharia796611@direct.shands.ufl.edu
Organizations & group practices 13
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.
-
- General Acute Care Hospital
- Yuma, AZ
- NPI 1194706655
-
- General Acute Care Hospital
- Boulder, CO
- NPI 1821074196
-
- Multi-Specialty Clinic/Center
- Great Falls, MT
- NPI 1801897780
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
Surgery
-
- General Acute Care Hospital
- Great Falls, MT
- NPI 1639109978
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1609822030
-
- Primary Care Clinic/Center
- Boulder, CO
- NPI 1740837137
-
- General Practice Physician
- Loveland, CO
- NPI 1366763260
-
- Surgery Physician
- Jacksonville, FL
- NPI 1588824858
-
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
-
- General Practice Physician
- Yuma, AZ
- NPI 1598993420
Hospital & facility affiliations 39
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751846400000",
"number": "1043472400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 560825",
"city": "DENVER",
"state": "CO",
"postal_code": "802560825",
"telephone_number": "719-595-7580",
"fax_number": "719-595-7417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 COURT ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032715",
"telephone_number": "719-562-2300"
}
],
"practiceLocations": [
{
"address_1": "2270 S Ridgeview Dr Ste 201",
"address_purpose": "LOCATION",
"city": "Yuma",
"state": "AZ",
"postal_code": "853648880",
"country_code": "US",
"telephone_number": "928-344-5055",
"fax_number": "928-336-6290",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HADJIZACHARIA",
"first_name": "PANTELIS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-26",
"last_updated": "2025-07-07",
"certification_date": "2025-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AZ",
"license": "R70524",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CO",
"license": "DR.0054955",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "AZ",
"license": "48372",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "CO",
"license": "CDRH.0054955",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "76507254",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.