Individual provider Active NPI

Guy J. Kovacevich, MD

  • Family Medicine Physician
  • Avon, CO
National Provider Identifier
1376629428
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30110 Issued in CO
Practice address
142 Beaver Creek Place
Avon, CO 81620
Phone
(970) 949-5434
Fax
(970) 949-0376
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30110 CO Primary

Addresses

Primary practice location

142 Beaver Creek Place
Avon, CO 81620

Mailing address

PO Box 2819
Avon, CO 81620-2819
Phone (970) 949-5434

Other identifiers 1

IdentifierTypeStateIssuer
C50461OtherPTAN

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
I20101007000610 CO Practitioner - General Practice 2264624345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Sanford School of Medicine of University of South Dakota, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

142 E Beaver Creek Blvd
Avon, CO 81620-4800
Phone (970) 949-5434

2819 PO Box
Avon, CO 81620

PO Box
Suite 2819
Avon, CO 81620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30110COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norm Numerof, MD, PC PastSince Sep 7, 2010 Accepting new patients
Doctors Plus of Colorado, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJJDAA/Endpoint/CJJDAA

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1376629428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2819",
            "city": "AVON",
            "state": "CO",
            "postal_code": "816202819",
            "telephone_number": "970-949-5434",
            "fax_number": "970-949-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 BEAVER CREEK PLACE",
            "city": "AVON",
            "state": "CO",
            "postal_code": "81620",
            "telephone_number": "970-949-5434",
            "fax_number": "970-949-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACEVICH",
        "first_name": "GUY",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "C50461",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CO

Sources for this page

Verify at the official NPI Registry.