NPIMap

Individual provider Active NPI

Thomas A Kenigsberg, M.D.

  • Family Medicine Physician
  • Johnstown, CO
National Provider Identifier
1467412650
Registry record updated Feb 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37268 Issued in CO
Practice address
222 Johnstown Center Dr
Johnstown, CO 80534-9030
Phone
(970) 587-4974
Fax
(970) 587-5466
NPI assigned
Mar 23, 2006
Last updated
Feb 13, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37268 CO Primary

Addresses

Primary practice location

222 Johnstown Center Dr
Johnstown, CO 80534-9030

Mailing address

1010 N Country Club Dr
Mesa, AZ 85201-3309
Phone (480) 461-2409

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050312000031 CO Practitioner - Family Practice 5395790398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

222 Johnstown Ctr Dr
Johnstown, CO 80534-9030
Phone (970) 587-4974

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37268COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2012 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2012 Accepting new patients
Precision Family Eyecare PC Past Accepting new patients
Banner Medical Group Greeley LLC Past Accepting new patients
Johnstown Family Physicians Past Accepting new patients
North Colorado Medical Center Past Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

222 Johnstown Center Dr
Johnstown, CO 80534
Phone (970) 587-4974

Organizations & group practices 7

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234483200000",
    "number": "1467412650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013309",
            "telephone_number": "480-461-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 JOHNSTOWN CENTER DR",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805349030",
            "telephone_number": "970-587-4974",
            "fax_number": "970-587-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENIGSBERG",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2009-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "37268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, CO

Sources for this page

Verify at the official NPI Registry.