NPIMap

Individual provider Active NPI

Samvel G Aznaurov, MD

  • Clinical Cardiac Electrophysiology Physician
  • Boulder, CO
National Provider Identifier
1740453752
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
1750 Issued in WI
Practice address
4743 Arapahoe Ave Ste 201
Boulder, CO 80303
Phone
(303) 442-2395
Fax
(303) 442-1073
NPI assigned
Apr 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 56378 CO
Clinical Cardiac Electrophysiology Physician 207RC0001X 56378 CO
Interventional Cardiology Physician 207RI0011X 56378 CO
Clinical Cardiac Electrophysiology Physician 207RC0001X 1750 WI Primary

Addresses

Primary practice location

4743 Arapahoe Ave Ste 201
Boulder, CO 80303

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 442-2395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220407002790 WI Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 5193027316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Kansas School of Med (KC/Wich/Sal), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-1000

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56378COMDClinical Cardiac Electrophysiology Physician
1750WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Apr 1, 2022 Accepting new patients
Boulder Community Health Past Accepting new patients
Prohealth Medical Group Inc Cardiovascular Disease Past Accepting new patients

Locations

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: samvel.aznaurov@hca3.eclinicaldirectplus.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1740453752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-442-2395",
            "fax_number": "303-442-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4743 ARAPAHOE AVE STE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80303",
            "telephone_number": "303-442-2395",
            "fax_number": "303-442-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZNAUROV",
        "first_name": "SAMVEL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "56378",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CO",
            "license": "56378",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CO",
            "license": "56378",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WI",
            "license": "1750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.