NPIMap

Individual provider Active NPI

Blaze Cook, MD

  • Vascular & Interventional Radiology Physician
  • Aurora, CO
National Provider Identifier
1437296704
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
CDRH.0046788 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0444551 KS
Diagnostic Radiology Physician 2085R0202X 13455C WY
Diagnostic Radiology Physician 2085R0202X 46788 CO
Vascular & Interventional Radiology Physician 2085R0204X CDRH.0046788 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

1819 Denver West Dr Ste 101
Lakewood, CO 80401-3172
Phone (303) 223-4448

Other practice location 1

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-0000

Other identifiers 1

IdentifierTypeStateIssuer
17586798MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080820000706 CO Practitioner - Diagnostic RadiologyPractitioner - Radiation Oncology 4385719640 Reassigns benefits to 3 organizations
I20210422001423 KS Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 4385719640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Radiation Oncology
Education
Albany Medical College of Union University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Colorado Imaging Associates P CGroup PAC ID 6800880055, 61 clinicians
Colorado Advanced Endovascular, LLCGroup PAC ID 7416485008, 13 clinicians

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527
Phone (303) 433-9729

355 Union Blvd
Suite 100
Lakewood, CO 80228-1500
Phone (720) 669-3036

401 E Spruce St
Garden City, KS 67846-5679
Phone (620) 272-2276

Hospital & facility affiliations

  • Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015
  • Centura Health-St Anthony North Health Campus Hospital, Westminster, CO, CCN 060104
  • Longmont United Hospital Hospital, Longmont, CO, CCN 060003
  • St. Catherine Hospital - Garden City Hospital, Garden City, KS, CCN 170023
  • Middle Park Medical Center Hospital, Kremmling, CO, CCN 061318

Merit-based Incentive Payment System (MIPS)

Final score
86.64 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46788COMDDiagnostic Radiology Physician
0444551KSMDDiagnostic Radiology Physician
13455CWYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Aug 10, 2009 Accepting new patients
Denver Health and Hospital Authority CurrentSince Aug 10, 2009 Accepting new patients
Colorado Advanced Endovascular, LLC Vascular & Interventional Radiology CurrentSince Sep 24, 2024 Accepting new patients
Cher, LLC Diagnostic Radiology CurrentSince Apr 14, 2021 Accepting new patients
Colorado Imaging Associates P C Diagnostic Radiology CurrentSince May 1, 2021 Accepting new patients
Pahs Onpoint Imaging LLC Diagnostic Radiology CurrentSince Feb 1, 2021 Accepting new patients

Locations (25 of 55)

16320 W 64th Ave
Arvada, CO 80007
Phone (303) 925-4560

7375 W 52nd Ave
Ste 210
Arvada, CO 80002
Phone (720) 741-0810

16280 W 64th Ave
Arvada, CO 80007
Phone (720) 898-1110

1700 S Potomac St
Aurora, CO 80012
Phone (303) 418-7600

4715 Arapahoe Ave
Boulder, CO 80303
Phone (303) 385-2000

400 N Park Ave
Ste 1A
Breckenridge, CO 80424
Phone (970) 547-9200

286 16th St
Burlington, CO 80807
Phone (719) 346-5311

6031 E Woodmen Rd
Ste 200
Colorado Springs, CO 80923
Phone (719) 577-2555

310 County Road 14
Del Norte, CO 81132
Phone (719) 657-2510

1601 Lowell Blvd
Denver, CO 80204
Phone (303) 264-6900

7000 E Hampden Ave
Denver, CO 80224
Phone (330) 925-4199

777 Bannock St
Denver, CO 80204

2777 Mile High Stadium Cir
Denver, CO 80211
Phone (303) 825-8822

1800 N Williams St
Ste 200
Denver, CO 80218
Phone (303) 388-4876

1800 N Williams St
Ste 100
Denver, CO 80218
Phone (303) 285-5020

555 Prospect Ave
Estes Park, CO 80517
Phone (970) 586-2200

32214 Ellingwood Trl
Ste 210
Evergreen, CO 80439
Phone (303) 679-2020

1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320

760 Warner Dr
Golden, CO 80401
Phone (303) 925-4360

1000 Granby Park Dr S
Granby, CO 80446
Phone (970) 668-5771

235 W Fletcher St
Haxtun, CO 80731
Phone (970) 351-0999

9205 S Broadway
Ste 101
Highlands Ranch, CO 80129
Phone (720) 603-4353

1805 Shea Center Dr
Ste 301
Highlands Ranch, CO 80129
Phone (303) 357-2559

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

3280 S Wadsworth Blvd
Lakewood, CO 80227
Phone (303) 649-3620

Interoperability endpoints

  • Direct secure messaging: coloradoadvancedendovascular.blazecook@159105.advancedmd-direct.com
  • FHIR API: https://api.platform.athenahealth.com/9821/brand/7/csg/1/fhir/r4

Organizations & group practices 6

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1437296704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 DENVER WEST DR STE 101",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013172",
            "telephone_number": "303-223-4448",
            "fax_number": "720-501-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 W 2nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "80228",
            "country_code": "US",
            "telephone_number": "720-321-0000",
            "fax_number": "720-321-1711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "BLAZE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "0444551",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WY",
            "license": "13455C",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "46788",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CO",
            "license": "CDRH.0046788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17586798",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.