Active NPI
Joseph A Tyburczy, MD
- Surgery Physician
- Greeley, CO
National Provider Identifier
1386682086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 21451
- Practice address
- 1800 15TH St
Suite 210
Greeley, CO 80631 - Phone
- (970) 352-8216
- Fax
- (970) 352-5297
- NPI assigned
- Jun 3, 2006
- Last updated
- Jan 6, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 21451 | CO | Primary |
Addresses
Primary practice location
1800 15TH St
Suite 210
Greeley, CO 80631
Mailing address
1800 15TH St
Suite 210
Greeley, CO 80631
Phone (970) 352-8216
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01214519 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21451 | CO | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Greeley Specialists | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Greeley, CO
- NPI 1558595611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262736000000",
"number": "1386682086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 15TH ST",
"address_2": "SUITE 210",
"city": "GREELEY",
"state": "CO",
"postal_code": "80631",
"telephone_number": "970-352-8216",
"fax_number": "970-352-5297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 15TH ST",
"address_2": "SUITE 210",
"city": "GREELEY",
"state": "CO",
"postal_code": "80631",
"telephone_number": "970-352-8216",
"fax_number": "970-352-5297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYBURCZY",
"first_name": "JOSEPH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2010-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CO",
"license": "21451",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01214519",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
- Turning Point Center for Youth and Family Development Inc.
- Turning Point Center for Youth and Family Development, Inc.
- Turning Point Center for Youth and Family, Inc
- Jaclyn Twaddle
- Jaiden Ward Twining
- Jeffrey Tyer II, D.O.
- Stephen Michael Tyman
- Uchealth Greeley Hospital
- Uchealth Greeley Hospital
- Nicholas Ryan Umholtz
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.