Individual provider Active NPI

Craig George Kozak, DC, PA-C, MSPAS

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1477677110
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
660 Bannock St FL 6
Denver, CO 80204-4506
Phone
(303) 602-1590
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4879 CO
Physician Assistant 363A00000X CO Primary

Addresses

Primary practice location

660 Bannock St FL 6
Denver, CO 80204-4506

Mailing address

1250 N Pearl St Apt 2
Denver, CO 80203-2539
Phone (720) 841-1239

Other practice location 1

45 County Road 804
Suite 211
Fraser, CO 80442-1945
Phone (970) 726-8150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228002531 CO Practitioner - Physician Assistant 5991852519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.65 of 100Reported as group
Quality
92.15
Promoting interoperability
100
Improvement activities
40
Cost
80.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4879COMDAddiction (Substance Use Disorder) Counselor
27621CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Dec 1, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Dec 1, 2022 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

777 Bannock St
Ste MC3450
Denver, CO 80204

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: ckozak273515@direct.dhha.org

Organizations & group practices 3

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 3

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1477677110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N PEARL ST APT 2",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802032539",
            "telephone_number": "720-841-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST FL 6",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "303-602-1590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 County Road 804",
            "address_2": "Suite 211",
            "address_purpose": "LOCATION",
            "city": "Fraser",
            "state": "CO",
            "postal_code": "804421945",
            "country_code": "US",
            "telephone_number": "970-726-8150",
            "fax_number": "970-281-4284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "CRAIG",
        "middle_name": "GEORGE",
        "credential": "DC, PA-C, MSPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4879",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.