Individual provider Active NPI

Robert A Leibold, M.D.

  • Diagnostic Radiology Physician
  • Lakewood, CO
National Provider Identifier
1598724171
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
31786 Issued in CO
Practice address
11600 W 2ND PL
Lakewood, CO 80228-1527
Phone
(720) 321-0000
Fax
(720) 321-1621
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 31786 CO Primary

Addresses

Primary practice location

11600 W 2ND PL
Lakewood, CO 80228-1527

Mailing address

PO Box 223897
Pittsburgh, PA 15251-2897
Phone (720) 501-5000

Other identifiers 2

IdentifierTypeStateIssuer
300122674OtherCORAILROAD MEDICRAE
01523562MedicaidCO

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
I20040526001683 CO Practitioner - Diagnostic RadiologyPractitioner - Radiation Oncology 5395726327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31786COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pahs Onpoint Imaging LLC Diagnostic Radiology CurrentSince Feb 1, 2021 Accepting new patients
Schryver Medical Sales and Marketing Inc. Past Accepting new patients
New Schryver LLC Past Accepting new patients

Locations

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9821/brand/7/csg/1/fhir/r4

Organizations & group practices 4

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1598724171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 223897",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152512897",
            "telephone_number": "720-501-5000",
            "fax_number": "303-458-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281527",
            "telephone_number": "720-321-0000",
            "fax_number": "720-321-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOLD",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "31786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICRAE",
            "identifier": "300122674",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01523562",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.