Individual provider Active NPI

Bradley Terence Zastrow, MD

  • Child & Adolescent Psychiatry Physician
  • Denver, CO
National Provider Identifier
1558823450
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
DR.0068757 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4597
Phone
(303) 303-4364
Fax
(303) 602-6931
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 73758 WI
Child & Adolescent Psychiatry Physician 2084P0804X DR.0068757 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4597

Mailing address

777 Bannock St
Denver, CO 80204-4597
Phone (303) 303-4364

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918001339 CO Practitioner - PsychiatryPractitioner - Pediatric Medicine 3678984010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Pediatric Medicine
Education
Medical College of Wisconsin, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0068757COMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Sep 1, 2023 Accepting new patients
Denver Health and Hospital Authority General Practice CurrentSince Aug 24, 2024 Accepting new patients
University Physicians Incorporated Current Accepting new patients
University Physicians, Incorporated CurrentSince Sep 1, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Aug 24, 2024 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

1890 N Revere Ct
Aurora, CO 80045
Phone (303) 724-1000

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

777 Bannock St
Denver, CO 80204

Dept 1061
Denver, CO 80256

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.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1558823450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-303-4364",
            "fax_number": "303-602-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-303-4364",
            "fax_number": "303-602-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZASTROW",
        "first_name": "BRADLEY",
        "middle_name": "TERENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "73758",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "DR.0068757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.