Mary G Heyrosa MD LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

DR0044751 Issued in CO

Legal business name

MARY G HEYROSA MD LLC

Practice address

157 Steele St
1St Floor
Denver, CO 80206-8020

Phone

(720) 575-9300

Fax

(720) 575-9566

NPI assigned

Nov 20, 2013

Organization subpart

No

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

Authorized official

Name

Mary Grace Heyrosa, MD

Title

Owner

Phone

(720) 483-5690

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1356771802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 E 20TH AVE",
            "address_2": "STE 370 #444",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053278",
            "telephone_number": "720-483-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 STEELE ST",
            "address_2": "1ST FLOOR",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802068020",
            "telephone_number": "720-575-9300",
            "fax_number": "720-575-9566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2427 Lawrence St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802052128",
            "country_code": "US",
            "telephone_number": "720-232-5323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2611 Larimer St",
            "address_2": "Loft",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802058020",
            "country_code": "US",
            "telephone_number": "720-722-1839",
            "fax_number": "720-302-0950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARY G HEYROSA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-20",
        "last_updated": "2021-08-16",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "HEYROSA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-483-5690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "DR0044751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85929760",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Denver, CO
• Providers in Denver, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.