Daffer Ghanim, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

TL.0007036 Issued in CO

Practice address

3055 Roslyn Street
Suite #100
Denver, CO 80238

Phone

(720) 553-2696

Fax

(720) 848-9050

NPI assigned

Apr 26, 2018

Reactivated

Dec 10, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1831687755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 ROSLYN STREET",
            "address_2": "SUITE #100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80238",
            "telephone_number": "720-553-2696",
            "fax_number": "720-848-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 ROSLYN STREET",
            "address_2": "SUITE #100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80238",
            "telephone_number": "720-553-2696",
            "fax_number": "720-848-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANIM",
        "first_name": "DAFFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-12-10",
        "deactivation_date": "2018-11-29",
        "reactivation_date": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL.0007036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Morse Geyman, PT
• Gfma Acq, LLC
• Roxana Ghaderi
• Bijan Ghaffari, MD
• Amy Eeman Ghaibeh, MD
• Adam Gharzita
• Usama Ghazi, DO
• Val Gheller, R.PH.
• Amanda Lynn Ghighi, MS, RDN
• Tunde Ghincea, M.D.

• Student in an Organized Health Care Education/Training Program in Denver, CO
• Providers in Denver, CO by specialty
• Student in an Organized Health Care Education/Training Program in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.