Individual provider Active NPI

Peter Martinuzzi

  • Family Medicine Physician
  • Kirkland, WA
National Provider Identifier
1871620831
Registry record updated Mar 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37602 Issued in CO
Practice address
12040 NE 128TH St
Kirkland, WA 98034-3013
Phone
(425) 889-1890
Fax
(425) 899-1898
NPI assigned
Feb 27, 2007
Last updated
Mar 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37602 CO Primary

Addresses

Primary practice location

12040 NE 128TH St
Kirkland, WA 98034-3013

Mailing address

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 889-1890

Other identifiers 2

IdentifierTypeStateIssuer
011142OtherKAISER-COMMERCIAL NUMBER
53501578MedicaidCO

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
I20090318000538 CO Practitioner - Family Practice 1355426859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Afterours IncGroup PAC ID 6103865787, 24 clinicians

Practice addresses (Care Compare)

6895 E Hampden Ave
Denver, CO 80224-3047
Phone (303) 861-7878

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37602COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Afterours Inc CurrentSince Aug 1, 2013 Accepting new patients
Highlands Ranch Healthcare LLC Past Accepting new patients
Mancelona Family Practice Family Medicine Past Accepting new patients
Mancelona Family Practice Family Medicine Past Accepting new patients

Locations

1900 N Grant St
Ste 1000
Denver, CO 80203
Phone (303) 407-0508

4500 W 38th Ave
Ste 220
Denver, CO 80212
Phone (303) 218-7754

6895 E Hampden Ave
Denver, CO 80224
Phone (303) 861-7878

101 W Mineral Ave
Ste 105
Littleton, CO 80120
Phone (303) 861-7878

3212 E 104th Ave
Thornton, CO 80233
Phone (303) 861-7878

3655 E 104th Ave
Thornton, CO 80233
Phone (303) 254-8500

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331337600000",
    "number": "1871620831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-889-1890",
            "fax_number": "425-899-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-889-1890",
            "fax_number": "425-899-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINUZZI",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "37602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "011142",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53501578",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.