Individual provider Active NPI

Stephen M. Konieczny, PA

  • Medical Physician Assistant
  • Denver, CO
National Provider Identifier
1689775447
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0002307 Issued in CO
Practice address
1290 N Broadway Ste 1400
Denver, CO 80203-5605
Phone
(303) 409-4444
Fax
(347) 440-0031
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2307 CO
Medical Physician Assistant 363AM0700X PA.0002307 CO Primary

Addresses

Primary practice location

1290 N Broadway Ste 1400
Denver, CO 80203-5605

Mailing address

4550 Montgomery Ave Ste 3
Bethesda, MD 20814-3886
Phone (313) 488-4332

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250124000599 CO Order and Referring Only - Physician Assistant 2769480599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2307COMDOptometrist
PA.0002307COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Emergency Group, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephen.konieczny.1@27127.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1689775447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 MONTGOMERY AVE STE 3",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143886",
            "telephone_number": "313-488-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 N BROADWAY STE 1400",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802035605",
            "telephone_number": "303-409-4444",
            "fax_number": "347-440-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIECZNY",
        "first_name": "STEPHEN",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2307",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0002307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.