Jeremy D Nussbaumer, MD
Individual provider Active NPI Anesthesiology Physician · Greenwood Village, CO
NPI 1407836745 · NPPES record last updated Jan 9, 2020
Key facts
- NPI
- 1407836745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 42375 (CO)
- Practice address
- 8000 E Maplewood Ave Ste 200
Greenwood Village, CO 80111-4727 - Phone
- (303) 438-3999
- Fax
- (720) 439-9500
- NPI assigned
- Jan 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040521001333 | CO | Practitioner - Anesthesiology | 0547251001 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42375 | CO | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 42375 | CO | Yes |
Addresses
Primary practice location
8000 E Maplewood Ave Ste 200
Greenwood Village, CO 80111-4727
Mailing address
8000 E Maplewood Ave Ste 200
Greenwood Village, CO 80111-4727
Phone (303) 438-3999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54302871 | Medicaid | CO |
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- Kristen Marie Nowakowski
- Sarah Nudd
- Chiquita Nunez
- Brian Matthew Nutter
- Charles W Nutting
- Dexter G Nye
- Frank Randall Nye III
- Jennifer O'Brien
All providers in Greenwood Village, CO · Anesthesiology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.