Individual provider Active NPI

Alireza Eghtedar, M.D.

  • Hematology & Oncology Physician
  • Denver, CO
National Provider Identifier
1811280431
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
55429 Issued in CO
Practice address
1721 E 19TH Ave Ste 300
Denver, CO 80218-1258
Phone
(720) 754-4800
Fax
(720) 754-4801
NPI assigned
May 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 55429 CO
Hematology & Oncology Physician 207RH0003X 55429 CO Primary
Emergency Medicine Physician 207P00000X N9365 TX
Internal Medicine Physician 207R00000X 4301099957 MI

Addresses

Primary practice location

1721 E 19TH Ave Ste 300
Denver, CO 80218-1258

Mailing address

4900 S Monaco St Ste 210
Denver, CO 80237-3487
Phone (720) 754-4800

Other identifiers 1

IdentifierTypeStateIssuer
78133530MedicaidCO

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
I20150811005201 CO Practitioner - Hematology/Oncology 7719155969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthone Clinic Services - Oncology Hematology LLCGroup PAC ID 9436293461, 47 clinicians

Practice addresses (Care Compare)

1721 E 19TH Ave
Suite 300
Denver, CO 80218-1251
Phone (720) 754-4800

Hospital & facility affiliations

  • HCA HealthOne Presbyterian St. Lukes Hospital, Denver, CO, CCN 060014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55429COMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthone Clinic Services - Oncology Hematology LLC Hematology & Oncology CurrentSince Jul 1, 2015 Accepting new patients
HCA Healthone LLC Past Accepting new patients

Locations

1721 E 19th Ave
Ste 200
Denver, CO 80218
Phone (303) 839-6745

1721 E 19th Ave
Ste 300
Denver, CO 80218
Phone (720) 748-4800

4900 S Monaco St
Ste 210
Denver, CO 80237

3676 Parker Blvd
Ste 350
Pueblo, CO 81008
Phone (719) 296-6000

525 W 15th St
Ste 200
Pueblo, CO 81003
Phone (719) 296-6000

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 1

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1811280431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST STE 210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373487",
            "telephone_number": "720-754-4800",
            "fax_number": "720-754-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 E 19TH AVE STE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181258",
            "telephone_number": "720-754-4800",
            "fax_number": "720-754-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGHTEDAR",
        "first_name": "ALIREZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-16",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "55429",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CO",
            "license": "55429",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N9365",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301099957",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78133530",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.