NPIMap

Individual provider Active NPI

Marc Y Wasserman, M.D.

  • Neurology Physician
  • Littleton, CO
National Provider Identifier
1356340467
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DR.0050778 Issued in CO
Practice address
8155 Piney River Ave Ste 100
Littleton, CO 80125-8729
Phone
(303) 265-3390
Fax
(720) 274-0064
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036110646 IL
Neurology Physician 2084N0400X 37826 AZ
Neurology Physician 2084N0400X DR.0050778 CO Primary

Addresses

Primary practice location

8155 Piney River Ave Ste 100
Littleton, CO 80125-8729

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

Other identifiers 1

IdentifierTypeStateIssuer
305105MedicaidAZ

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
I20120306000196 CO Practitioner - Neurology 0941241871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Medical College of Wisconsin, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

8155 Piney River Ave
Suite 100
Littleton, CO 80125-8729
Phone (303) 265-3370

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110646ILMDSpecialist
DR.0050778COMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Specialist Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Oct 8, 2021 Accepting new patients
Carepoint P.C. Neurology CurrentSince Jan 1, 2013 Accepting new patients
Carepoint Inpatient Blue Sky Neurology PLLC Neurology Past Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients
Privia Medical Group Arizona, LLC Neurology Past Accepting new patients

Locations

401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

175 Inverness Dr W
Ste 300
Englewood, CO 80112
Phone (720) 516-9092

8155 Piney River Ave
Ste 100
Littleton, CO 80125
Phone (303) 265-3370

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1024 Central Park Dr
Steamboat Springs, CO 80487
Phone (970) 824-1322

9141 Grant St
Ste B40
Thornton, CO 80229
Phone (303) 453-2554

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 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1356340467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "fax_number": "720-274-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8155 PINEY RIVER AVE STE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801258729",
            "telephone_number": "303-265-3390",
            "fax_number": "720-274-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "MARC",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036110646",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "37826",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0050778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305105",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.