Paul Jordan Fishman, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

17709 Issued in CO

Practice address

3885 Upham St
100
Wheat Ridge, CO 80033-4880

Phone

(303) 742-0108

Fax

(303) 742-0690

NPI assigned

Aug 24, 2006

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

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1912014002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3885 UPHAM ST",
            "address_2": "100",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334880",
            "telephone_number": "303-742-0108",
            "fax_number": "303-742-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 UPHAM ST",
            "address_2": "100",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334880",
            "telephone_number": "303-742-0108",
            "fax_number": "303-742-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "PAUL",
        "middle_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "17709",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CO",
            "license": "17709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRW MEDICARE",
            "identifier": "110086492",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01177096",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bohuslav Finta, M.D.
• First Sip Lactation LLC
• Michael G Firth, M.D.
• Emma Maureen Fisher
• Stephen Martin Fisher, OD
• Brittney Fitzgerald
• Katherine Fitzgerald, RN
• Emma Rose Fitzpatrick, LAC & MFTC
• Michelle Lee Flake, M.A.
• Maribeth Eileen Flanagan, LPC

• Geriatric Medicine (Internal Medicine) Physician in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Geriatric Medicine (Internal Medicine) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.