Individual provider Active NPI

Ronald T Genova, M.D.

  • Emergency Medicine Physician
  • Lyons, CO
National Provider Identifier
1083699805
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31133 Issued in CO
Practice address
1554 Rowell Dr
Lyons, CO 80540-8332
Phone
(303) 823-6619
Fax
(303) 823-6909
NPI assigned
Dec 14, 2005
Last updated
Jun 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 31133 CO Primary

Addresses

Primary practice location

1554 Rowell Dr
Lyons, CO 80540-8332

Mailing address

1554 Rowell Dr
Lyons, CO 80540-8332
Phone (303) 589-7881

Other identifiers 1

IdentifierTypeStateIssuer
01311331MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31133COMDEmergency Medicine Physician
3133AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Arizona Inc Emergency Medicine Current Accepting new patients
Nes Arizona Inc Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Emergency Physicians Professional Association LTD Emergency Medicine Past Accepting new patients
Phoenix Physician Group, PLLC Past Accepting new patients
Mountain Vista Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Tempe Emergency Physicians, LTD Emergency Medicine Past Accepting new patients
Exigence Arizona LLC Past Accepting new patients
Cherokee Emergency Services, LLC Past Accepting new patients

Locations

450 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-2261

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

7300 State Highway 121
Ste 374
McKinney, TX 75070

Organizations & group practices 8

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1083699805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 ROWELL DR",
            "city": "LYONS",
            "state": "CO",
            "postal_code": "805408332",
            "telephone_number": "303-589-7881",
            "fax_number": "303-823-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 ROWELL DR",
            "city": "LYONS",
            "state": "CO",
            "postal_code": "805408332",
            "telephone_number": "303-823-6619",
            "fax_number": "303-823-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENOVA",
        "first_name": "RONALD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "31133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01311331",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, CO

Sources for this page

Verify at the official NPI Registry.