Active NPI
Mary Elizabeth Ciezki, MD
- Surgery Physician
- Colorado Springs, CO
National Provider Identifier
1245201797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 40061
- Practice address
- 1633 Medical Center PT
Colorado Springs, CO 80907-5700 - Phone
- (719) 475-9800
- Fax
- (719) 473-5436
- NPI assigned
- Jan 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 40061 | CO | Primary |
Addresses
Primary practice location
1633 Medical Center PT
Colorado Springs, CO 80907-5700
Mailing address
2 S Cascade Ave
140
Colorado Springs, CO 80903-1624
Phone (719) 538-2950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61522848 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35391 | CO | MD | Family Medicine Physician |
| 40061 | CO | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1245201797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 S CASCADE AVE",
"address_2": "140",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809031624",
"telephone_number": "719-538-2950",
"fax_number": "719-538-2996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1633 MEDICAL CENTER PT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809075700",
"telephone_number": "719-475-9800",
"fax_number": "719-473-5436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIEZKI",
"first_name": "MARY ELIZABETH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-31",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CO",
"license": "40061",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "61522848",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.