NPIMap

Individual provider Active NPI

Bryan Kujawa, MD

  • Family Medicine Physician
  • Ft Carson, CO
National Provider Identifier
1235456013
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0063154 Issued in CO
Practice address
1650 Cochrane Cir # B7500
Ft Carson, CO 80913-4613
Phone
(419) 344-7603
NPI assigned
May 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26536 NE
Family Medicine Physician 207Q00000X DR.0063154 CO Primary

Addresses

Primary practice location

1650 Cochrane Cir # B7500
Ft Carson, CO 80913-4613

Mailing address

1650 Cochrane Cir # B7500
Ft Carson, CO 80913-4613

Other practice location 1

320 E Fontanero St Ste 100
Colorado Springs, CO 80907-7535
Phone (719) 365-7420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200329000420 CO Practitioner - Family Practice 8527497460 Reassigns benefits to 1 organization
I20210526001475 TX Practitioner - Family Practice 8527497460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Uniformed Services Uhs Fe Hebert School of Med, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

320 E Fontanero St
Suite 100 Uchealth Primary Care Fontanero
Colorado Springs, CO 80907-7535
Phone (719) 365-7420

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0063154COMDFamily Medicine Physician
26536NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince May 3, 2021 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Apr 10, 2020 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Apr 10, 2020 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

320 E Fontanero St
Ste 100
Colorado Springs, CO 80907
Phone (719) 327-5660

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

Organizations & group practices 3

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1235456013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR # B7500",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR # B7500",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "419-344-7603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 E Fontanero St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809077535",
            "country_code": "US",
            "telephone_number": "719-365-7420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUJAWA",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "26536",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0063154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Carson, CO

Sources for this page

Verify at the official NPI Registry.