Individual provider Active NPI

John Eun, MD

  • Vascular Surgery Physician
  • Centennial, CO
National Provider Identifier
1659418937
Registry record updated Feb 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
DR0051583 Issued in CO
Practice address
5657 S Himalaya St Ste 210
Centennial, CO 80015-5309
Phone
(800) 991-6117
NPI assigned
Jan 30, 2007
Last updated
Feb 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL-2055 CO
Vascular Surgery Physician 2086S0129X DR0051583 CO Primary
Phlebology Physician 202K00000X DR0051583 CO

Addresses

Primary practice location

5657 S Himalaya St Ste 210
Centennial, CO 80015-5309

Mailing address

3820 Northdale Blvd Ste 201
Tampa, FL 33624-1893
Phone (800) 991-6117

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
I20150902000263 CO Practitioner - Vascular Surgery 0446570394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Medical College of Georgia School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Medical Group PLLCGroup PAC ID 5890091409, 11 clinicians

Practice addresses (Care Compare)

5657 S Himalaya St
Suite 210
Centennial, CO 80015-5309
Phone (800) 991-6117

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0051583COMDVascular Surgery Physician
TL-2055COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Medical Group, PLLC Vascular Surgery CurrentSince Nov 1, 2023 Accepting new patients
Colorado Medical Group, PLLC Vascular Surgery PastSince Oct 1, 2020 Accepting new patients
Colorado Medical Group, PLLC Vascular Surgery Past Accepting new patients
Colorado Medical Group, PLLC Vascular Surgery Past Accepting new patients
Colorado Medical Group, PLLC Vascular Surgery Past Accepting new patients

Locations

5657 S Himalaya St
Ste 210
Centennial, CO 80015

6979 S Holly Cir
Ste 125
Centennial, CO 80112

3535 S Lafayette St
Ste 100
Englewood, CO 80113
Phone (303) 788-0600

3665 John F Kennedy Pkwy
Bldg 200
Fort Collins, CO 80525

6179 S Balsam Way
Ste 200
Littleton, CO 80123
Phone (303) 933-2555

1551 Professional Ln
Unit 241
Longmont, CO 80501

9195 Grant St
Ste 300
Thornton, CO 80229
Phone (303) 280-2229

3810 Northdale Blvd
Ste 150
Tampa, FL 33624
Phone (813) 683-4784

3810 Northdale Blvd
Ste 260
Tampa, FL 33624

3820 Northdale Blvd
Ste 201
Tampa, FL 33624

Interoperability endpoints

  • Direct secure messaging: john.eun@uvvc.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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1659418937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 NORTHDALE BLVD STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241893",
            "telephone_number": "800-991-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5657 S HIMALAYA ST STE 210",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800155309",
            "telephone_number": "800-991-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUN",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL-2055",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CO",
            "license": "DR0051583",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "CO",
            "license": "DR0051583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.