Organization Active NPI

Conrad J Tirre M D P C

  • Plastic Surgery Physician
  • Denver, CO
National Provider Identifier
1205028370
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
031474 Issued in CO
Legal business name
CONRAD J TIRRE M D P C
Practice address
1578 Humboldt St
Denver, CO 80218-1638
Phone
(303) 830-7200
Fax
(303) 830-7523
NPI assigned
Aug 13, 2007
Last updated
Oct 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Authorized official

Name
Dr. Conrad J Tirre, MD
Title
Self
Phone
(303) 830-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 031474 CO Primary

Addresses

Primary practice location

1578 Humboldt St
Denver, CO 80218-1638

Mailing address

1578 Humboldt St
Denver, CO 80218-1638
Phone (303) 830-7200

Other identifiers 1

IdentifierTypeStateIssuer
01314749MedicaidCO

National Provider Directory

National Provider Directory

Locations

1578 N Humboldt St
Denver, CO 80218
Phone (303) 382-3965

2535 S Downing St
Ste 440
Denver, CO 80210
Phone (303) 459-2150

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1205028370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1578 HUMBOLDT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181638",
            "telephone_number": "303-830-7200",
            "fax_number": "303-830-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1578 HUMBOLDT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181638",
            "telephone_number": "303-830-7200",
            "fax_number": "303-830-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONRAD J TIRRE M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "TIRRE",
        "authorized_official_first_name": "CONRAD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SELF",
        "authorized_official_telephone_number": "303-830-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CO",
            "license": "031474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01314749",
            "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 Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.