NPIMap

Individual provider Active NPI

Michael J. Pramenko, MD

  • Family Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1619950201
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0036454 Issued in CO
Practice address
3150 N 12TH St
Grand Junction, CO 81506-2863
Phone
(970) 245-1220
Fax
(970) 245-9148
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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.0036454 CO Primary

Addresses

Primary practice location

3150 N 12TH St
Grand Junction, CO 81506-2863

Mailing address

PO Box 10700
Grand Junction, CO 81502-5517
Phone (970) 254-2642

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
I20101105001183 CO Practitioner - Family Practice 8224119102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Partners IncGroup PAC ID 7810893161, 58 clinicians

Practice addresses (Care Compare)

3150 N 12TH St
Grand Junction, CO 81506-2863
Phone (970) 245-1220

Hospital & facility affiliations

  • Hopewest Grand Junction Hospice, Grand Junction, CO, CCN 061527
  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • Family Health West Hospital Hospital, Fruita, CO, CCN 061302
  • Community Hospital Hospital, Grand Junction, CO, CCN 060054

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0036454COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Jul 18, 2018 Accepting new patients
Primary Care Partners, Inc. Family Medicine CurrentSince Sep 1, 1998 Accepting new patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Jul 18, 2018 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Family Medicine Current Accepting new patients
Primary Care Partners, Inc. Family Medicine CurrentSince Sep 1, 1998 Accepting new patients
Primary Care Partners, Inc. Past Accepting new patients

Locations

3150 N 12th St
Grand Junction, CO 81506
Phone (970) 243-5437

2698 Patterson Rd
Grand Junction, CO 81506
Phone (970) 298-2800

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Interoperability endpoints

  • Direct secure messaging: michaelpramenko@pcp.allscriptsdirect.net

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1619950201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10700",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815025517",
            "telephone_number": "970-254-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N 12TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815062863",
            "telephone_number": "970-245-1220",
            "fax_number": "970-245-9148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAMENKO",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0036454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.