Individual provider Active NPI

Mark B Trubowitz, D.O.

  • Geriatric Psychiatry Physician
  • Denver, CO
National Provider Identifier
1619011327
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
25010 Issued in CO
Practice address
10350 E Dakota Ave
Denver, CO 80247-1314
Phone
(303) 367-2970
NPI assigned
Feb 16, 2007
Last updated
Nov 21, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 25010 CO Primary

Addresses

Primary practice location

10350 E Dakota Ave
Denver, CO 80247-1314

Mailing address

Exempla West Pines
3400 Lutheran Parkway
Wheat Ridge, CO 80033-6035
Phone (303) 367-2970

Other identifiers 2

IdentifierTypeStateIssuer
01250109MedicaidCO
005129OtherKAISER-COMMERCIAL NUMBER

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
25010COMDGeriatric Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1619011327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EXEMPLA WEST PINES",
            "address_2": "3400 LUTHERAN PARKWAY",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336035",
            "telephone_number": "303-367-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314",
            "telephone_number": "303-367-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUBOWITZ",
        "first_name": "MARK",
        "middle_name": "B",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CO",
            "license": "25010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01250109",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "005129",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.