NPIMap

Individual provider Active NPI

Christopher Domen, PH.D.

  • Clinical Neuropsychologist
  • Aurora, CO
National Provider Identifier
1215284419
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3742 Issued in CO
Practice address
12605 E 16TH Ave
University of Colorado Hospital
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Aug 7, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 3742 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
University of Colorado Hospital
Aurora, CO 80045-2545

Mailing address

PO Box 110429
University Physicians Inc
Aurora, CO 80042-0429
Phone (303) 493-7000

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
I20130925000925 CO Practitioner - Clinical Psychologist 0941444244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3742COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Aug 1, 2013 Accepting new patients
University Physicians, Incorporated CurrentSince Aug 1, 2013 Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1635 Aurora Ct
Fl 4
Aurora, CO 80045
Phone (720) 848-2000

1635 Aurora Ct
Fl 5
Aurora, CO 80045
Phone (720) 848-2300

1635 Aurora Ct
Aurora, CO 80045
Phone (720) 848-1060

Dept 1061
Denver, CO 80256

Organizations & group practices 2

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1215284419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "address_2": "UNIVERSITY PHYSICIANS INC",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "address_2": "UNIVERSITY OF COLORADO HOSPITAL",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMEN",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-07",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "3742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.