NPIMap

Individual provider Active NPI

Robert Nicolas Petro, DO

  • Family Medicine Physician
  • Englewood, CO
National Provider Identifier
1215349642
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0058113 Issued in CO
Practice address
730 W Hampden Ave Ste 200
Englewood, CO 80110-2129
Phone
(720) 974-7464
Fax
(303) 953-7274
NPI assigned
May 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X DR.0058113 CO
Sports Medicine (Family Medicine) Physician 207QS0010X DR.0058113 CO
Family Medicine Physician 207Q00000X DR.0058113 CO Primary

Addresses

Primary practice location

730 W Hampden Ave Ste 200
Englewood, CO 80110-2129

Mailing address

750 W Hampden Ave Ste 105
Englewood, CO 80110-2167
Phone (303) 341-4730

Other identifiers 1

IdentifierTypeStateIssuer
9000173212MedicaidCO

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
I20190611000657 CO Practitioner - Family Practice 1951615814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9670 W Coal Mine Ave
200 WLNH Primary Care
Littleton, CO 80123-4004
Phone (303) 932-2121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0058113COMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Family Medicine CurrentSince Jun 23, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jun 23, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC Family Medicine Current Accepting new patients
Portercare Adventist Health System CurrentSince Aug 9, 2022 Accepting new patients
Portercare Adventist Health System CurrentSince Aug 9, 2022 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

9670 W Coal Mine Ave
Ste 200
Littleton, CO 80123
Phone (303) 392-2121

Interoperability endpoints

  • Direct secure messaging: rpetro2557344@adventhealth.direct-ci.com

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1215349642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W HAMPDEN AVE STE 105",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801102167",
            "telephone_number": "303-341-4730",
            "fax_number": "303-341-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 W HAMPDEN AVE STE 200",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801102129",
            "telephone_number": "720-974-7464",
            "fax_number": "303-953-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO",
        "first_name": "ROBERT",
        "middle_name": "NICOLAS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CO",
            "license": "DR.0058113",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CO",
            "license": "DR.0058113",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0058113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000173212",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.