Individual provider Active NPI

Alan M Mazur, PT

  • Physical Therapist
  • Denver, CO
National Provider Identifier
1669666582
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0012141 Issued in CO
Practice address
1385 S Colorado Blvd # a-620
Denver, CO 80222-3304
Phone
(303) 691-3733
Fax
(303) 680-8627
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070015953 IL
Physical Therapist 225100000X PTL.0012141 CO Primary

Addresses

Primary practice location

1385 S Colorado Blvd # a-620
Denver, CO 80222-3304

Mailing address

1385 S Colorado Blvd # a-620
Denver, CO 80222-3304
Phone (303) 691-3733

Other practice location 1

3451 S Chambers Rd
Aurora, CO 80014-5073
Phone (303) 680-6121

Other identifiers 1

IdentifierTypeStateIssuer
PTL.0012141OtherCOPHYSICAL THERAPY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140310000589 CO Practitioner - Physical Therapist in Private Practice 0143392555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Spine Therapy LLCGroup PAC ID 6608961677, 5 clinicians

Practice addresses (Care Compare)

1385 S Colorado Blvd
Suite 620
Denver, CO 80222-3324
Phone (303) 691-3733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0012141COMDPhysical Therapist
070015953ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Spine Therapy, LLC CurrentSince Sep 16, 2014 Accepting new patients

Locations

1385 S Colorado Blvd
Ste A620
Denver, CO 80222
Phone (303) 691-3733

1385 S Colorado Blvd
Ste 620
Denver, CO 80222
Phone (303) 691-3733

1385 S Colorado Blvd
Denver, CO 80222
Phone (303) 691-9756

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, 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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1669666582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 S COLORADO BLVD # A-620",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802223304",
            "telephone_number": "303-691-3733",
            "fax_number": "303-691-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 S COLORADO BLVD # A-620",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802223304",
            "telephone_number": "303-691-3733",
            "fax_number": "303-680-8627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3451 S Chambers Rd",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800145073",
            "country_code": "US",
            "telephone_number": "303-680-6121",
            "fax_number": "303-680-8627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "ALAN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015953",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0012141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PTL.0012141",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.