Individual provider Active NPI

Mariovisto F Frogozo, MD

  • Anesthesiology Physician
  • Montrose, CO
National Provider Identifier
1427006139
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
41866 Issued in CO
Practice address
800 S 3Rd St
Montrose, CO 81401-4212
Phone
(970) 249-2211
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 41866 CO Primary

Addresses

Primary practice location

800 S 3Rd St
Montrose, CO 81401-4212

Mailing address

PO Box 668
Arvada, CO 80001-0668
Phone (303) 422-9438

Other identifiers 1

IdentifierTypeStateIssuer
83133062MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040330000304 CO Practitioner - Anesthesiology 6901796705 Reassigns benefits to 1 organization
I20190307001208 NY Practitioner - Anesthesiology 6901796705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diehl Anesthesia IncGroup PAC ID 6800197575, 35 clinicians

Practice addresses (Care Compare)

9777 S Yosemite St
Suite 210
Lone Tree, CO 80124-3115
Phone (303) 951-7510

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296899NYMDLicensed Practical Nurse
41866COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Mount Vernon Hospital CurrentSince Sep 23, 2023 Accepting new patients
Oswego Hospital CurrentSince Sep 25, 2019 Accepting new patients
Diehl Anesthesia Inc Anesthesiology CurrentSince Oct 2, 2017 Accepting new patients
Oswego Hospital Anesthesiology CurrentSince Sep 25, 2019 Accepting new patients

Locations

9777 S Yosemite St
Ste 210
Lone Tree, CO 80124
Phone (303) 708-2943

9395 Crown Crest Blvd
Parker, CO 80138
Phone (303) 269-4000

12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

Organizations & group practices 4

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1427006139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800010668",
            "telephone_number": "303-422-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S 3RD ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014212",
            "telephone_number": "970-249-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROGOZO",
        "first_name": "MARIOVISTO",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "41866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83133062",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.