Individual provider Active NPI

Tori Niemynski, MD

  • Pediatrics Physician
  • Aurora, CO
National Provider Identifier
1417223322
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD61147545 Issued in WA
Practice address
13001 E 17TH PL
Aurora, CO 80045-2570
Phone
(303) 724-6031
NPI assigned
Mar 25, 2012
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD61147545 WA Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X DR.0055396 CO

Addresses

Primary practice location

13001 E 17TH PL
Aurora, CO 80045-2570

Mailing address

13001 E 17TH PL
Aurora, CO 80045-2570
Phone (303) 724-6031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20210622001239 WA Practitioner - Pediatric Medicine 0345558904 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61147545WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Pediatrics CurrentSince May 28, 2021 Accepting new patients
University Physicians Incorporated CurrentSince Sep 29, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince May 28, 2021 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Interoperability endpoints

  • Direct secure messaging: tniemynski44059@direct.childrenscolorado.org

Organizations & group practices 5

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": "1332633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1417223322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 E 17TH PL",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452570",
            "telephone_number": "303-724-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 E 17TH PL",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452570",
            "telephone_number": "303-724-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMYNSKI",
        "first_name": "TORI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-25",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61147545",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CO",
            "license": "DR.0055396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.