Individual provider Active NPI

Marc Jeffrey Friedman, DO

  • Neurology Physician
  • Colorado Springs, CO
National Provider Identifier
1699760173
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DR-27389 Issued in CO
Practice address
1725 E Boulder St
Ste 101
Colorado Springs, CO 80909-5768
Phone
(719) 365-6300
Fax
(719) 365-6094
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DR-27389 CO Primary

Addresses

Primary practice location

1725 E Boulder St
Ste 101
Colorado Springs, CO 80909-5768

Mailing address

1725 E. Boulder St.
Ste 101
Colorado Springs, CO 80909-5740
Phone (719) 365-6300

Other identifiers 1

IdentifierTypeStateIssuer
32026838MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5578OHMDOptometrist
DR-27389COMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health System Past Accepting new patients
Cleveland Hearing & Balance Center Inc Past Accepting new patients

Organizations & group practices 2

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1699760173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E. BOULDER ST.",
            "address_2": "STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095740",
            "telephone_number": "719-365-6300",
            "fax_number": "719-365-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E BOULDER ST",
            "address_2": "STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095768",
            "telephone_number": "719-365-6300",
            "fax_number": "719-365-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "MARC",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR-27389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32026838",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.