Active NPI
Ronald T Genova, M.D.
- Emergency Medicine Physician
- Lyons, CO
National Provider Identifier
1083699805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 31133
- 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, 2010
- 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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01311331 | Medicaid | CO |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31133 | CO | MD | Emergency Medicine Physician |
| 3133 | AZ | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nes Arizona Inc | Emergency Medicine | Current | Accepting new patients |
| Nes Arizona Inc | Emergency Medicine | Current | 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.
-
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-
- Emergency Medicine Physician
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- NPI 1285163121
-
- Emergency Medical Services (Emergency Medicine) Physician
- Atlanta, GA
- NPI 1992754717
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1114931490
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bullhead City, AZ
- NPI 1558311506
-
- Emergency Medicine Physician
- Mesa, AZ
- NPI 1164642963
-
- Emergency Medical Services (Emergency Medicine) Physician
- Mesa, AZ
- NPI 1154898435
-
- Emergency Medicine Physician
- Bullhead City, AZ
- NPI 1376934315
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.