Individual provider Active NPI

Robert Madayag, MD

  • Surgery Physician
  • Wheat Ridge, CO
National Provider Identifier
1336175751
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
39687 Issued in CO
Practice address
3455 Lutheran Pkwy
Suite 290
Wheat Ridge, CO 80033-6028
Phone
(303) 467-1400
Fax
(303) 467-1467
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 39687 CO Primary

Addresses

Primary practice location

3455 Lutheran Pkwy
Suite 290
Wheat Ridge, CO 80033-6028

Mailing address

3455 Lutheran Pkwy
Suite 290
Wheat Ridge, CO 80033-6028
Phone (303) 467-1400

Other identifiers 1

IdentifierTypeStateIssuer
04439597MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20070625000656 CO Practitioner - General Surgery 0143329672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Icahn School of Medicine at Mount Sinai, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Trauma Services PCGroup PAC ID 6800895947, 9 clinicians
Colorado Surgical Service PCGroup PAC ID 7416844311, 15 clinicians

Practice addresses (Care Compare)

3455 Lutheran Pkwy
Suite 290
Wheat Ridge, CO 80033-6034
Phone (303) 467-1400

400 Indiana St
Suite 200
Golden, CO 80401-5027
Phone (303) 467-1400

4350 Wadsworth Blvd
Suite 401
Wheat Ridge, CO 80033-4638

Hospital & facility affiliations

  • Intermountain Health Lutheran Hospital Hospital, Wheat Ridge, CO, CCN 060009

Merit-based Incentive Payment System (MIPS)

Final score
87.22 of 100Reported as group
Quality
80.56
Improvement activities
40
Cost
93.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39687COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Trauma Services PC CurrentSince Jan 1, 2006 Accepting new patients
Colorado Surgical Service PC Surgery CurrentSince Jul 1, 2001 Accepting new patients
Colorado Trauma Services PC Surgery CurrentSince Jan 1, 2006 Accepting new patients
Colorado Surgical Service PC Surgery CurrentSince Jul 1, 2001 Accepting new patients
Colorado Surgical Service PC Surgery Past Accepting new patients
Intermountain Front Range, Inc. Past Accepting new patients

Locations

6870 W 52nd Ave
Ste 102
Arvada, CO 80002
Phone (303) 534-0391

400 Indiana St
Ste 200
Golden, CO 80401
Phone (303) 467-1400

500 W 144th Ave
Ste 130
Westminster, CO 80023
Phone (303) 426-2130

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

4350 Wadsworth Blvd
Ste 401
Wheat Ridge, CO 80033
Phone (720) 996-0780

3455 Lutheran Pkwy
Ste 290
Wheat Ridge, CO 80033
Phone (303) 467-1400

Organizations & group practices 6

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 5

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1336175751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 LUTHERAN PKWY",
            "address_2": "SUITE 290",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336028",
            "telephone_number": "303-467-1400",
            "fax_number": "303-467-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 LUTHERAN PKWY",
            "address_2": "SUITE 290",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336028",
            "telephone_number": "303-467-1400",
            "fax_number": "303-467-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADAYAG",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "39687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04439597",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.