Active NPI
Edward K Raczka
- Primary Podiatric Medicine Podiatrist
- Denver, CO
National Provider Identifier
1114907482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- 298
- Practice address
- 850 E Harvard Ave
Suite 385
Denver, CO 80210-5073 - Phone
- (303) 762-1200
- Fax
- (303) 762-0508
- NPI assigned
- Jan 20, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 298 | CO | Primary |
| Sports Medicine Podiatrist | 213ES0000X | 298 | CO | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 298 | CO |
Addresses
Primary practice location
850 E Harvard Ave
Suite 385
Denver, CO 80210-5073
Mailing address
850 E Harvard Ave
Suite 385
Denver, CO 80210-5073
Phone (303) 762-1200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01002989 | Medicaid | CO | |
| 7047 | Other | CO | BC/BS PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 298 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1114907482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 E HARVARD AVE",
"address_2": "SUITE 385",
"city": "DENVER",
"state": "CO",
"postal_code": "802105073",
"telephone_number": "303-762-1200",
"fax_number": "303-762-0508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 E HARVARD AVE",
"address_2": "SUITE 385",
"city": "DENVER",
"state": "CO",
"postal_code": "802105073",
"telephone_number": "303-762-1200",
"fax_number": "303-762-0508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RACZKA",
"first_name": "EDWARD",
"middle_name": "K",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-20",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "CO",
"license": "298",
"primary": true
},
{
"code": "213ES0000X",
"taxonomy_group": "",
"desc": "Podiatrist, Sports Medicine",
"state": "CO",
"license": "298",
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CO",
"license": "298",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01002989",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER #",
"identifier": "7047",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.