NPIMap

Individual provider Active NPI

Melody Sun Mar, M.D.

  • Diagnostic Radiology Physician
  • Colorado Springs, CO
National Provider Identifier
1356781231
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DR.0063107 Issued in CO
Practice address
2222 N Nevada Ave
Colorado Springs, CO 80907-6819
Phone
(719) 593-1799
Fax
(719) 265-3794
NPI assigned
Jun 25, 2013
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DR.0063107 CO Primary

Addresses

Primary practice location

2222 N Nevada Ave
Colorado Springs, CO 80907-6819

Mailing address

1390 Kelly Johnson Blvd
Colorado Springs, CO 80920-3908
Phone (719) 593-1799

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Other practice location 2

20 York Street
Department of Radiology
New Haven, CT 06510-3220
Phone (203) 688-4242

Other identifiers 2

IdentifierTypeStateIssuer
9000179179MedicaidCO
125-063128OtherILILLINOIS STATE LICENSE

Other names 1

  • Melody Sun Former name

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
I20200110001672 CO Practitioner - Diagnostic Radiology 2769720002 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Springs Radiologists PCGroup PAC ID 6901890094, 27 clinicians
Penrad Imaging LLCGroup PAC ID 1850387598, 26 clinicians

Practice addresses (Care Compare)

2222 N Nevada Ave
Colorado Springs, CO 80907-6819
Phone (719) 265-3775

3050 N Circle Dr
Colorado Springs, CO 80909-1175
Phone (719) 593-1799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.1 of 100Reported as group
Quality
76.59
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
85
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0063107COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penrad Imaging LLC CurrentSince Jan 1, 2020 Accepting new patients
Colorado Springs Radiologists PC Diagnostic Radiology CurrentSince Jan 1, 2020 Accepting new patients

Locations

1390 Kelly Johnson Blvd
Colorado Springs, CO 80920
Phone (714) 400-6934

2222 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 776-5333

3050 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 550-1200

6001 E Woodmen Rd
Colorado Springs, CO 80923
Phone (719) 571-1000

6011 E Woodmen Rd
Ste 10
Colorado Springs, CO 80923

Interoperability endpoints

  • Direct secure messaging: mmar416042@direct.ynhh.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1356781231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 KELLY JOHNSON BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203908",
            "telephone_number": "719-593-1799",
            "fax_number": "719-265-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076819",
            "telephone_number": "719-593-1799",
            "fax_number": "719-265-3794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York Street",
            "address_2": "Department of Radiology",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAR",
        "first_name": "MELODY",
        "middle_name": "SUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0063107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000179179",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS STATE LICENSE",
            "identifier": "125-063128",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELODY",
            "last_name": "SUN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.