Individual provider Active NPI

Samuel Douglas Richesin II, M.D.

  • Internal Medicine Physician
  • Denver, CO
National Provider Identifier
1336313196
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
49956 Issued in CO
Practice address
501 28TH St
Denver, CO 80205-3003
Phone
(303) 602-6333
Fax
(303) 436-4610
NPI assigned
Apr 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 49956 CO Primary

Addresses

Primary practice location

501 28TH St
Denver, CO 80205-3003

Mailing address

2685 Xanthia St
Denver, CO 80238-2550
Phone (720) 454-2220

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address srichesin10975@direct.dhha.org Health Information Exchange (HIE)

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
I20110624000571 CO Practitioner - Internal Medicine 2062690829 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49956COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Apr 22, 2011 Accepting new patients
Denver Health and Hospital Authority CurrentSince Apr 22, 2011 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

501 28th St
Denver, CO 80205
Phone (303) 436-4600

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: srichesin10975@direct.dhha.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1336313196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 XANTHIA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382550",
            "telephone_number": "720-454-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 28TH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053003",
            "telephone_number": "303-602-6333",
            "fax_number": "303-436-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHESIN",
        "first_name": "SAMUEL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "49956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srichesin10975@direct.dhha.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.