Individual provider Active NPI

Thiyagarajan Raju Meyappan, MD

  • Pediatric Critical Care Medicine Physician
  • Denver, CO
National Provider Identifier
1770661126
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
49969 Issued in CO
Practice address
1719 E 19TH Ave
RMCH - Pediatric Intensive Care Unit - 3Rd Floor
Denver, CO 80218-1235
Phone
(720) 754-4300
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X M4879 TX
Pediatric Critical Care Medicine Physician 2080P0203X 49969 CO Primary
Pediatric Critical Care Medicine Physician 2080P0203X 238275-1 NY

Addresses

Primary practice location

1719 E 19TH Ave
RMCH - Pediatric Intensive Care Unit - 3Rd Floor
Denver, CO 80218-1235

Mailing address

1719 E 19TH Ave
RMCH - Pediatric Intensive Care Unit - 3Rd Floor
Denver, CO 80218-1235
Phone (720) 754-4300

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
I20201022003861 CO Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 9234231911 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49969COMDPediatric Critical Care Medicine Physician
238275-1NYMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Colorado P C CurrentSince Sep 5, 2020 Accepting new patients
Obstetrix Medical Group of Colorado P C Pediatric Critical Care Medicine CurrentSince Sep 5, 2020 Accepting new patients
HCA Healthone LLC Past Accepting new patients

Locations

4722 N 24th St
Ste 150
Phoenix, AZ 85016
Phone (602) 256-4628

1719 E 19th Ave
Unit 3RD
Denver, CO 80218
Phone (720) 754-4300

1719 E 19th Ave
Denver, CO 80218
Phone (303) 839-6000

2055 N High St
Ste 255
Denver, CO 80205
Phone (303) 799-3468

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Organizations & group practices 3

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1770661126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 E 19TH AVE",
            "address_2": "RMCH - PEDIATRIC INTENSIVE CARE UNIT - 3RD FLOOR",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181235",
            "telephone_number": "720-754-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 E 19TH AVE",
            "address_2": "RMCH - PEDIATRIC INTENSIVE CARE UNIT - 3RD FLOOR",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181235",
            "telephone_number": "720-754-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYAPPAN",
        "first_name": "THIYAGARAJAN",
        "middle_name": "RAJU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "M4879",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CO",
            "license": "49969",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "238275-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.