Individual provider Active NPI

Glenn D Sakamoto, MD

  • Colon & Rectal Surgery Physician
  • Englewood, CO
National Provider Identifier
1851489801
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
30131 Issued in CO
Practice address
401 W Hampden PL
Suite 210
Englewood, CO 80110-2470
Phone
(303) 722-6960
Fax
(303) 722-0462
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 30131 CO Primary

Addresses

Primary practice location

401 W Hampden PL
Suite 210
Englewood, CO 80110-2470

Mailing address

3333 S Bannock St
Suite 350
Englewood, CO 80110-2432
Phone (303) 957-1310

Other identifiers 1

IdentifierTypeStateIssuer
01301316MedicaidCO

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 Medicine

State licenses

LicenseStateTypeSpecialty
30131COMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Surgery Center LLC PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1851489801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S BANNOCK ST",
            "address_2": "SUITE 350",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801102432",
            "telephone_number": "303-957-1310",
            "fax_number": "303-761-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W HAMPDEN PL",
            "address_2": "SUITE 210",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801102470",
            "telephone_number": "303-722-6960",
            "fax_number": "303-722-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKAMOTO",
        "first_name": "GLENN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CO",
            "license": "30131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01301316",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.