Individual provider Active NPI

Morgan Johonn Kizzar, DPM

  • Foot & Ankle Surgery Podiatrist
  • Canon City, CO
National Provider Identifier
1912261074
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0000747 Issued in CO
Practice address
604 S 9TH St
Canon City, CO 81212-4910
Phone
(719) 275-1037
Fax
(877) 807-4835
NPI assigned
Jul 3, 2012
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0000747 CO Primary

Addresses

Primary practice location

604 S 9TH St
Canon City, CO 81212-4910

Mailing address

PO Box 576
Canon City, CO 81215-0576
Phone (719) 275-1037

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150522002021 CO Practitioner - Podiatry 3870813330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

604 S 9TH St
Canon City, CO 81212-4910
Phone (719) 275-1037

Merit-based Incentive Payment System (MIPS)

Final score
91.13 of 100Reported as individual
Quality
79.06
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue32
Removal of skin lesions27
Removal of nail tissue1296
Removal or shaving of skin growth250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000747COMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of Colorado PLLC CurrentSince Jul 1, 2015 Accepting new patients

Locations

1336 Bauer Ln
#B
Canon City, CO 81212
Phone (719) 275-1037

1336 Bauer Ln
Ste B
Canon City, CO 81212
Phone (719) 275-1037

604 S 9th St
Canon City, CO 81212
Phone (719) 275-1037

Interoperability endpoints

  • Direct secure messaging: dr.kizzar@faasocp-co.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, 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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1912261074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812150576",
            "telephone_number": "719-275-1037",
            "fax_number": "877-807-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124910",
            "telephone_number": "719-275-1037",
            "fax_number": "877-807-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZZAR",
        "first_name": "MORGAN",
        "middle_name": "JOHONN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "0000747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.