Vassily T Eliopoulos, MD

Individual provider Active NPI Emergency Medicine Physician · Superior, CO

NPI 1215149463 · NPPES record last updated Nov 12, 2024

Key facts

NPI
1215149463
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
50371 (CO)
Practice address
3 Superior Dr Ste 225
Superior, CO 80027-8661
Phone
(303) 414-2083
Fax
(303) 414-2042
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50371COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Plus LLC Emergency Medicine Past Accepting new patients
Cape Cod Emergency Associates LLP Emergency Medicine Past
since Oct 30, 2022
Accepting new patients
Cape Cod Emergency Associates, LLC Emergency Medicine Past Accepting new patients
Maimonides Medical Center - MMC Emergency Physicians FPP Emergency Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 50371 CO Yes

Addresses

Primary practice location

3 Superior Dr Ste 225
Superior, CO 80027-8661

Mailing address

3 Superior Dr Ste 225
Superior, CO 80027-8661
Phone (303) 414-2083

Other identifiers

IdentifierTypeStateIssuer
24551830MedicaidCO
20326023101OtherPACIFICARE SECURE HORIZONS
605960009OtherWYUSDLAB
P01075423OtherRR MEDICARE
1215149463MedicaidWY
315252OtherWYBSWY

Other providers in Superior, CO

All providers in Superior, CO · Emergency Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.