NPIMap

Individual provider Active NPI

Kenneth D Danylchuk, MD, PH.D.

  • Specialist
  • Pueblo, CO
National Provider Identifier
1770684409
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
29760 Issued in CO
Practice address
3530 E Spaulding Ave
Pueblo, CO 81008-2209
Phone
(719) 296-9000
Fax
(719) 296-9001
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 29760 CO Primary

Addresses

Primary practice location

3530 E Spaulding Ave
Pueblo, CO 81008-2209

Mailing address

3530 E Spaulding Ave
Pueblo, CO 81008-2209
Phone (719) 296-9000

Other identifiers 1

IdentifierTypeStateIssuer
01297605MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20101115001252 CO Practitioner - Orthopedic Surgery 5991799074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenneth D Danylchuk, MD, PCGroup PAC ID 0042204109, 4 clinicians

Practice addresses (Care Compare)

3530 E Spaulding Ave
Pueblo, CO 81008-2209
Phone (719) 296-9000

3530 Spaulding Ave
Peublo, CO 81008-2209

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.5 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78.34

Merit-based Incentive Payment System (MIPS)

Final score
75.69 of 100Reported as group
Quality
71.4
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Spinal fusion18
Laminectomy or laminotomy (partial removal of spine bones)20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29760COMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth D Danylchuk, MD, PC Specialist CurrentSince Aug 11, 2000 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

3530 E Spaulding Ave
Pueblo, CO 81008
Phone (719) 296-0077

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

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.

Hospital & facility affiliations 12

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1770684409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 E SPAULDING AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082209",
            "telephone_number": "719-296-9000",
            "fax_number": "719-296-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 E SPAULDING AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082209",
            "telephone_number": "719-296-9000",
            "fax_number": "719-296-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANYLCHUK",
        "first_name": "KENNETH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD, PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "29760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01297605",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.