NPIMap

Individual provider Active NPI

Emily Anna Reznicek, MD

  • Family Medicine Physician
  • Louisville, CO
National Provider Identifier
1619474822
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0064314 Issued in CO
Practice address
80 Health Park Dr Ste 100
Louisville, CO 80027-4644
Phone
(303) 666-2710
Fax
(303) 673-0438
NPI assigned
Apr 12, 2018
Last updated
Jun 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X DR.0064314 CO Primary

Addresses

Primary practice location

80 Health Park Dr Ste 100
Louisville, CO 80027-4644

Mailing address

80 Health Park Dr Ste 100
Louisville, CO 80027-4644
Phone (303) 673-0448

Other practice location 1

191 E Orchard Rd Ste 200
Littleton, CO 80121-8057
Phone (303) 788-3151

Other names 1

  • Emily Anna Frese Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913000972 CO Practitioner - Family Practice 3375899412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Medical Center, PCGroup PAC ID 4183536204, 86 clinicians

Practice addresses (Care Compare)

80 Health Park Dr
Suite 100
Louisville, CO 80027-4644
Phone (303) 673-0448

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0064314COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Medical Center, P.C. CurrentSince Sep 13, 2021 Accepting new patients
Boulder Medical Center, P.C. Current Accepting new patients
Boulder Medical Center, P.C. CurrentSince Sep 13, 2021 Accepting new patients
Swedish Family Medicine Providers, PC Family Medicine Past Accepting new patients
Medical Center Pharmacy Inc Past Accepting new patients

Locations

2750 Broadway St
Boulder, CO 80304
Phone (303) 440-3000

80 Health Park Dr
Ste 100
Louisville, CO 80027
Phone (303) 666-2710

Interoperability endpoints

  • Direct secure messaging: emily.frese@hca3.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 44

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1619474822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HEALTH PARK DR STE 100",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800274644",
            "telephone_number": "303-673-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HEALTH PARK DR STE 100",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800274644",
            "telephone_number": "303-666-2710",
            "fax_number": "303-673-0438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 E Orchard Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801218057",
            "country_code": "US",
            "telephone_number": "303-788-3151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZNICEK",
        "first_name": "EMILY",
        "middle_name": "ANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0064314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "FRESE",
            "middle_name": "ANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, CO

Sources for this page

Verify at the official NPI Registry.