NPIMap

Individual provider Active NPI

Julie Pysklo, MD

  • Internal Medicine Physician
  • Durango, CO
National Provider Identifier
1124092572
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34933 Issued in CO
Practice address
1010 Three Springs Blvd
Durango, CO 81301-8296
Phone
(970) 247-4311
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 34933 CO
Internal Medicine Physician 207R00000X 34933 CO Primary

Addresses

Primary practice location

1010 Three Springs Blvd
Durango, CO 81301-8296

Mailing address

1010 Three Springs Blvd
Durango, CO 81301-8296
Phone (970) 247-4311

Other identifiers 1

IdentifierTypeStateIssuer
01349331MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013001171 CO Practitioner - Internal Medicine 0840250999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Colorado School of Medicine, Denver, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Total HealthcareGroup PAC ID 1052214814, 27 clinicians

Practice addresses (Care Compare)

810 E 3Rd St
201 PRMN PC Mercy North
Durango, CO 81301-5759
Phone (970) 764-1790

Hospital & facility affiliations

  • Home Health Mercy Home health agency, Durango, CO, CCN 067119
  • Pasco/SW Home Health Home health agency, Cortez, CO, CCN 067339
  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013
  • Southwest Memorial Hospital Hospital, Cortez, CO, CCN 061327

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34933COMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Healthcare CurrentSince Jan 18, 2016 Accepting new patients
Total Healthcare Current Accepting new patients
Valley-Wide Health Systems, Inc. Past Accepting new patients
Presbyterian Denver Ekg Internal Medicine Past Accepting new patients
Total Healthcare Internal Medicine Past Accepting new patients
Total Healthcare Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

480 Wolverine Dr
Ste 3
Bayfield, CO 81122
Phone (970) 764-9150

810 E 3rd St
Unit 201
Durango, CO 81301
Phone (970) 764-1790

1 Mercado St
Ste 160
Durango, CO 81301
Phone (970) 385-9850

1010 Three Springs Blvd
Durango, CO 81301
Phone (970) 247-4311

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 7

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1124092572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "970-247-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "970-247-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYSKLO",
        "first_name": "JULIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "34933",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "34933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01349331",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.