Individual provider Active NPI

Tibor Kereshi

  • Diagnostic Radiology Physician
  • Colorado Springs, CO
National Provider Identifier
1104897685
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DR.0059910 Issued in CO
Practice address
1633 Medical Center PT
Suite 3950
Colorado Springs, CO 80907-5700
Phone
(719) 667-4139
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DR.0059910 CO Primary

Addresses

Primary practice location

1633 Medical Center PT
Suite 3950
Colorado Springs, CO 80907-5700

Mailing address

2 S Cascade Ave Ste 140
Suite 3950
Colorado Springs, CO 80903-1604

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180720001275 CO Practitioner - Interventional RadiologyPractitioner - Other (Physician) 4587678313 Reassigns benefits to 2 organizations
I20200811002567 PA Practitioner - Diagnostic Radiology 4587678313 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0059910COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Colorado Medical Group LLC CurrentSince Jul 9, 2018 Accepting new patients
Geisinger Clinic Current Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Dec 14, 2020 Accepting new patients
University of Pittsburgh Physicians Diagnostic Radiology CurrentSince Feb 15, 2021 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Jul 9, 2018 Accepting new patients

Locations

1633 Medical Center Pt
Colorado Springs, CO 80907
Phone (719) 636-2999

1633 Medical Center Pt
Ste 3950
Colorado Springs, CO 80907
Phone (719) 667-4139

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

423 N 21st St
Ste 202
Camp Hill, PA 17011
Phone (717) 763-9880

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

100 N Academy Ave
Danville, PA 17822

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1104897685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S CASCADE AVE STE 140",
            "address_2": "SUITE 3950",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 MEDICAL CENTER PT",
            "address_2": "SUITE 3950",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075700",
            "telephone_number": "719-667-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERESHI",
        "first_name": "TIBOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2021-06-15",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0059910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.