Individual provider Active NPI

Ananya Guha, M.D.

  • Pediatrics Physician
  • Canon City, CO
National Provider Identifier
1699972992
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR.0054382 Issued in CO
Practice address
1338 Phay Ave BLDG D
Canon City, CO 81212-2326
Phone
(719) 285-2091
Fax
(719) 285-2092
NPI assigned
Jun 29, 2007
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0054382 CO Primary
Pediatrics Physician 208000000X RS20070322 NM

Addresses

Primary practice location

1338 Phay Ave BLDG D
Canon City, CO 81212-2326

Mailing address

1338 Phay Ave BLDG D
Canon City, CO 81212-2326
Phone (719) 285-2091

Other names 1

  • Ananya Guha Lusero Former name

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
I20150302001603 CO Practitioner - Pediatric Medicine 2668509167 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0054382COMDPediatrics Physician
RS20070322NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 30, 2014 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 30, 2014 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

1335 Phay Ave
Ste A
Canon City, CO 81212
Phone (719) 275-4151

614 Yale Pl
Canon City, CO 81212
Phone (719) 275-4151

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1699972992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVE BLDG D",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122326",
            "telephone_number": "719-285-2091",
            "fax_number": "719-285-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVE BLDG D",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122326",
            "telephone_number": "719-285-2091",
            "fax_number": "719-285-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUHA",
        "first_name": "ANANYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0054382",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "RS20070322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANANYA",
            "last_name": "LUSERO",
            "middle_name": "GUHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.