Active NPI
Stewart Leslie Greisman, D.O.
- Emergency Medicine Physician
- Avon, CO
National Provider Identifier
1831201607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 18796
- Practice address
- 50 Buck Creek Road
Suite 200
Avon, CO 81620 - Phone
- (970) 926-6340
- Fax
- (970) 926-6348
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 18796 | CO | Primary |
Addresses
Primary practice location
50 Buck Creek Road
Suite 200
Avon, CO 81620
Mailing address
PO Box 4330
Avon, CO 81620-4330
Phone (970) 926-6340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1187962 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18796 | CO | MD | Emergency Medicine Physician |
| 1876 | CO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Breckenridge Medical Clinic, LLC | Emergency Medicine | Past | Accepting new patients |
| Vail Clinic, Inc. | Past | Accepting new patients | |
| VVMC Diversified Services | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Breckenridge, CO
- NPI 1376682740
Emergency Medicine
-
- Specialist
- Keystone, CO
- NPI 1386725406
-
- Specialist
- Edwards, CO
- NPI 1730279712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473897600000",
"number": "1831201607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4330",
"city": "AVON",
"state": "CO",
"postal_code": "816204330",
"telephone_number": "970-926-6340",
"fax_number": "970-926-6348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 BUCK CREEK ROAD",
"address_2": "SUITE 200",
"city": "AVON",
"state": "CO",
"postal_code": "81620",
"telephone_number": "970-926-6340",
"fax_number": "970-926-6348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREISMAN",
"first_name": "STEWART",
"middle_name": "LESLIE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2016-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "18796",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1187962",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.