Individual provider Active NPI

Fanni Barbara Cardenas, MD, MPH

  • Emergency Medicine Physician
  • Denver, CO
National Provider Identifier
1629655972
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0072881 Issued in CO
Practice address
777 Bannock Street, MC 0108
Denver, CO 80204
Phone
(303) 602-5193
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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
Emergency Medicine Physician 207P00000X DR.0072881 CO Primary

Addresses

Primary practice location

777 Bannock Street, MC 0108
Denver, CO 80204

Mailing address

777 Bannock Street, MC 0108
Denver, CO 80204

Other practice location 1

12505 E 16TH Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Other practice location 2

10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
9000230347MedicaidCO
029570OtherCOKAISER COMMERCIAL NUMBER

Other names 1

  • Fanni Barbara Mandy Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240517003170 CO Practitioner - Emergency Medicine 8921449158
I20251001002761 TX Practitioner - Emergency Medicine 8921449158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical School at Houston, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6410 Fannin St
Suite 135
Houston, TX 77030-3003

6414 Fannin St
Suite G125
Houston, TX 77030-1517

Hospital & facility affiliations

  • Memorial Hermann - Texas Medical Center Hospital, Houston, TX, CCN 450068
  • Harris Health Hospital, Houston, TX, CCN 450289

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Ut Physicians Emergency Medicine CurrentSince Nov 1, 2025 Accepting new patients
Ut Physicians CurrentSince Nov 1, 2025 Accepting new patients
University Physicians Incorporated Emergency Medicine Current Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

11820 Destination Dr
Broomfield, CO 80021
Phone (303) 460-6000

10350 E Dakota Ave
Ofc
Denver, CO 80247
Phone (303) 344-7771

Dept 1061
Denver, CO 80256

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

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.

Hospital & facility affiliations 3

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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1629655972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK STREET, MC 0108",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK STREET, MC 0108",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80204",
            "telephone_number": "303-602-5193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12505 E 16TH AVE",
            "address_purpose": "LOCATION",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10350 E Dakota Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802471314",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "FANNI",
        "middle_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0072881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000230347",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029570",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10350 E Dakota Ave",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802471314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "FANNI",
            "last_name": "MANDY",
            "middle_name": "BARBARA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.