Individual provider Active NPI

John Nozykowski, MD

  • Family Medicine Physician
  • Fruita, CO
National Provider Identifier
1083103196
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0063205 Issued in CO
Practice address
101 Jurassic Ave Unit B
Fruita, CO 81521-7713
Phone
(970) 858-6677
Fax
(970) 858-6679
NPI assigned
May 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0063205 CO Primary

Addresses

Primary practice location

101 Jurassic Ave Unit B
Fruita, CO 81521-7713

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 858-6677

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
I20210913002142 CO Practitioner - Family Practice 7315296274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albany Medical College of Union University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Group LLCGroup PAC ID 1052612785, 109 clinicians

Practice addresses (Care Compare)

551 Kokopelli Blvd
Unit F
Fruita, CO 81521-6305
Phone (970) 858-6677

Hospital & facility affiliations

  • Community Hospital Hospital, Grand Junction, CO, CCN 060054
  • Family Health West Hospital Hospital, Fruita, CO, CCN 061302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Group, LLC CurrentSince Aug 1, 2021 Accepting new patients
Community Medical Group, LLC Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Community Medical Group, LLC Current Accepting new patients
Community Medical Group, LLC Family Medicine Past Accepting new patients
Community Medical Group, LLC Family Medicine Past Accepting new patients
St Mary'S Hospital and Medical Center, Inc Family Medicine Past Accepting new patients

Locations

551 Kokopelli Blvd
Unit F
Fruita, CO 81521
Phone (970) 858-2530

101 Jurassic Ave
Unit B
Fruita, CO 81521
Phone (970) 858-6677

2478 Patterson Rd
Ste 27
Grand Junction, CO 81505
Phone (970) 257-1862

731 Iowa Ave
Ste A
Palisade, CO 81526
Phone (970) 644-4050

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1083103196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-858-6677",
            "fax_number": "970-858-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 JURASSIC AVE UNIT B",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815217713",
            "telephone_number": "970-858-6677",
            "fax_number": "970-858-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOZYKOWSKI",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-03",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0063205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruita, CO

Sources for this page

Verify at the official NPI Registry.