Individual provider Active NPI

Eugene P Podrazik, M.D.

  • Otolaryngology Physician
  • Casper, WY
National Provider Identifier
1265418834
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
6478A Issued in WY
Practice address
2210 King Blvd.
Casper, WY 82604
Phone
(307) 577-4242
Fax
(307) 577-0012
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 6478A WY Primary

Addresses

Primary practice location

2210 King Blvd.
Casper, WY 82604

Mailing address

2210 King Blvd.
Casper, WY 82604
Phone (307) 577-4242

Other identifiers 3

IdentifierTypeStateIssuer
310642OtherBLUE CROSS BLUE SHIELD
040015424OtherRAILROAD MEDICARE
115763900MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100202000335 WY Practitioner - OtolaryngologyPractitioner - Maxillofacial Surgery 6002819737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Maxillofacial Surgery
Education
Rush Medical College of Rush University, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyoming Otolaryngology, P.C.Group PAC ID 4082696570, 6 clinicians

Practice addresses (Care Compare)

2210 King Blvd
Casper, WY 82604-3165
Phone (307) 577-4240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.74 of 100Reported as group
Quality
100
Improvement activities
40
Cost
95.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J2739TXMDInterventional Cardiology Physician
6478AWYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Otolaryngology, P.C. Otolaryngology CurrentSince Jul 1, 2006 Accepting new patients
Wyoming Otolaryngology, P.C. PastSince Jul 28, 2024 Accepting new patients

Locations

2210 King Blvd
Casper, WY 82604
Phone (307) 577-4240

Interoperability endpoints

  • Direct secure messaging: epodrazik@yourcarecommunity.org

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1265418834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 KING BLVD.",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82604",
            "telephone_number": "307-577-4242",
            "fax_number": "307-577-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 KING BLVD.",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82604",
            "telephone_number": "307-577-4242",
            "fax_number": "307-577-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODRAZIK",
        "first_name": "EUGENE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WY",
            "license": "6478A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "310642",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "040015424",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115763900",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.