Individual provider Active NPI

Lenny Sujdak, DO

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1619171436
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR-48686 Issued in CO
Practice address
7789 Tejon St
Denver, CO 80221-4216
Phone
(303) 952-9011
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR-48686 CO Primary

Addresses

Primary practice location

7789 Tejon St
Denver, CO 80221-4216

Mailing address

7789 Tejon St
Denver, CO 80221-4216
Phone (303) 952-9011

Other practice location 1

12001 W 63rd Pl
Arvada, CO 80004-4034
Phone (303) 423-1360

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
I20110131001006 CO Practitioner - Family Practice 4082893417 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR-48686COMDFamily Medicine Physician

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1619171436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7789 TEJON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802214216",
            "telephone_number": "303-952-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7789 TEJON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802214216",
            "telephone_number": "303-952-9011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12001 W 63rd Pl",
            "address_purpose": "LOCATION",
            "city": "Arvada",
            "state": "CO",
            "postal_code": "800044034",
            "country_code": "US",
            "telephone_number": "303-423-1360",
            "fax_number": "303-423-1640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUJDAK",
        "first_name": "LENNY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR-48686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.