Active NPI
Colby Nielsen, MD
- Orthopaedic Surgery Physician
- Phoenix, AZ
National Provider Identifier
1093418170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 390200000X
- Practice address
- 1111 E McDowell Rd
Phoenix, AZ 85006-2612 - Phone
- (602) 839-2000
- NPI assigned
- Mar 27, 2023
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 390200000X | AZ | Primary |
Addresses
Primary practice location
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Mailing address
1350 S Greenfield Rd Unit 1222
Mesa, AZ 85206-3503
Phone (480) 390-7066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230710001163 | AZ | Order and Referring Only - Orthopedic Surgery | 0345609350 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1093418170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 S GREENFIELD RD UNIT 1222",
"city": "MESA",
"state": "AZ",
"postal_code": "852063503",
"telephone_number": "480-390-7066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 E MCDOWELL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062612",
"telephone_number": "602-839-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSEN",
"first_name": "COLBY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-27",
"last_updated": "2023-03-27",
"certification_date": "2023-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AZ",
"license": "390200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.