Individual provider Active NPI

Attilio Bruce Catanzano, MD

  • Psychiatry Physician
  • Boulder, CO
National Provider Identifier
1518139591
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21511 Issued in CO
Practice address
255 Canyon Blvd
Boulder, CO 80302-4979
Phone
(303) 449-7541
Fax
(303) 449-8973
NPI assigned
Mar 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 21511 CO Primary

Addresses

Primary practice location

255 Canyon Blvd
Boulder, CO 80302-4979

Mailing address

PO Box 151029
Lakewood, CO 80215-9029
Phone (303) 986-9504

Other identifiers 1

IdentifierTypeStateIssuer
04141040MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21511COMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Foundation for Human Development PC Psychiatry PastSince Jun 1, 2008 Accepting new patients

Organizations & group practices 1

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": "1206835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1518139591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151029",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802159029",
            "telephone_number": "303-986-9504",
            "fax_number": "303-980-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 CANYON BLVD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024979",
            "telephone_number": "303-449-7541",
            "fax_number": "303-449-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATANZANO",
        "first_name": "ATTILIO",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-30",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "21511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04141040",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.