NPIMap

Individual provider Active NPI

Marchyarn Mahathanaruk, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Lakewood, CO
National Provider Identifier
1265674287
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
DR.0054219 Issued in CO
Practice address
11700 W 2ND PL Ste 225
Lakewood, CO 80228-1707
Phone
(303) 661-4100
Fax
(720) 321-8969
NPI assigned
Apr 6, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X DR.0054219 CO Primary

Addresses

Primary practice location

11700 W 2ND PL Ste 225
Lakewood, CO 80228-1707

Mailing address

PO Box 800022
Kansas City, MO 64180-0022
Phone (800) 953-0104

Other practice location 1

300 Union Blvd
Suite 600
Lakewood, CO 80228-1535
Phone (716) 536-2168

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
I20150630001069 CO Practitioner - AnesthesiologyPractitioner - Pain Management 3173835428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527

11650 W 2ND PL
Lakewood, CO 80228-1527

11700 W 2ND PL
Lakewood, CO 80228-1707

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Feb 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince May 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince May 1, 2018 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Feb 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Locations

11700 W 2nd Pl
Ste 210
Lakewood, CO 80228
Phone (720) 321-8080

11700 W 2nd Pl
Ste 225
Lakewood, CO 80228
Phone (720) 321-8950

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

80 Health Park Dr
Ste 270
Louisville, CO 80027
Phone (303) 269-2085

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 8

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 4

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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1265674287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800022",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 W 2ND PL STE 225",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281707",
            "telephone_number": "303-661-4100",
            "fax_number": "720-321-8969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Union Blvd",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281535",
            "country_code": "US",
            "telephone_number": "716-536-2168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHATHANARUK",
        "first_name": "MARCHYARN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-06",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CO",
            "license": "DR.0054219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.