Robert R Nystrom, D.O.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

30464 Issued in CO

Practice address

1900 16TH St
Greeley, CO 80631-5114

Phone

(970) 350-2471

Fax

(970) 350-2418

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

College of Osteo Med of the Pacific at Pomona, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Urgent Care ColoradoGroup PAC ID 7214295989, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Banner Urgent Care Colorado

  • Urgent Care Clinic/Center
  • Loveland, CO
  • NPI 1902316995
  Medicare reassignment Care Compare group NPD
• Banner Urgent Care Colorado

  • Urgent Care Clinic/Center
  • Loveland, CO
  • NPI 1346750288
  NPD
• Banner Urgent Care Colorado

  • Urgent Care Clinic/Center
  • Greeley, CO
  • NPI 1679055438
  NPD
• Banner Medical Group Greeley LLC

  • Multi-Specialty Clinic/Center
  • Johnstown, CO
  • NPI 1386817880
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1902936107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-350-2471",
            "fax_number": "970-350-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-350-2471",
            "fax_number": "970-350-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYSTROM",
        "first_name": "ROBERT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30464",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "30464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1304641",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00931173",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elise Nowicki
• Abdul Nabi Bin Nur Alam
• Chima C Nwizu, MD
• Nnenna O Nwizu, NP
• Haley Nyarko
• Jaime O'Berry, BA
• Kayla E O'Brien, B.A., R.P.
• Caitlin E O'Connor, CRNA
• Evelyn Kathleen O'Donahue, PT, DPT
• Cullen O'Hearne

• General Practice Physician in Greeley, CO
• Providers in Greeley, CO by specialty
• General Practice Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.