Todd C Dextradeur, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DR.0035500 Issued in CO

Practice address

51 W 84TH Ave
Ste 300
Thornton, CO 80260-4883

Phone

(303) 777-8333

Fax

(303) 777-8338

NPI assigned

May 9, 2006

Last updated

Oct 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Todd Dextradeur MD PC

  • Internal Medicine Physician
  • Thornton, CO
  • NPI 1881864072
  Medicare reassignment Authorized official
• Critical Care Pulmonary and Sleep Associates Professional LLP

  • Critical Care Medicine (Internal Medicine) Physician
  • Lakewood, CO
  • NPI 1437100039
  NPD (past)
• Critical Care Pulmonary and Sleep Associates Professional LLP

  • Critical Care Medicine (Internal Medicine) Physician
  • Highlands Ranch, CO
  • NPI 1871487355
  NPD (past)
• Rocky Mountain Primary Care , PC

  • Family Medicine Physician
  • Westminster, CO
  • NPI 1215981634

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1801845532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 SOUTH RACE STREET",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80210",
            "telephone_number": "303-777-8333",
            "fax_number": "303-777-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 W 84TH AVE",
            "address_2": "STE 300",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802604883",
            "telephone_number": "303-777-8333",
            "fax_number": "303-777-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEXTRADEUR",
        "first_name": "TODD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0035500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "35500",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01355007",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathie Roxanne Deschaine, MS, LPC, LAC
• Jenna Desormier, P.T., D.P.T., ATC
• Jennifer Anne Dessel, AU.D.
• Geoffroy Destenaves, DMD
• Developmental Behavioral Health, Inc. (Developmental Behavioral Home Health)
• Amrita K Dhaliwal, OD
• Bintou Diallo
• Alexia Diaz
• Rosalinda Diaz, NP
• Katherine Dicamillo

• Internal Medicine Physician in Thornton, CO
• Providers in Thornton, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.