Individual provider Active NPI

Joel Shebowich, MD

  • Internal Medicine Physician
  • Centennial, CO
National Provider Identifier
1366468902
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29860 Issued in CO
Practice address
13111 E Briarwood Ave Ste 215
Centennial, CO 80112-3846
Phone
(303) 680-9150
Fax
(303) 680-9149
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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 29860 CO Primary

Addresses

Primary practice location

13111 E Briarwood Ave Ste 215
Centennial, CO 80112-3846

Mailing address

13111 E Briarwood Ave Ste 215
Centennial, CO 80112-3846
Phone (303) 680-9150

Other identifiers 1

IdentifierTypeStateIssuer
01298603MedicaidCO

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
I20120313000282 CO Practitioner - Internal Medicine 0749177152

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29860COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joel Shebowich MD PC Internal Medicine CurrentSince May 1, 2002 Accepting new patients

Locations

13111 E Briarwood Ave
Centennial, CO 80112
Phone (303) 649-9950

13111 E Briarwood Ave
Ste 215
Centennial, CO 80112
Phone (303) 680-9150

Organizations & group practices 1

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1366468902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13111 E BRIARWOOD AVE STE 215",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123846",
            "telephone_number": "303-680-9150",
            "fax_number": "303-680-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 E BRIARWOOD AVE STE 215",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123846",
            "telephone_number": "303-680-9150",
            "fax_number": "303-680-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEBOWICH",
        "first_name": "JOEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "29860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01298603",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.