Individual provider Active NPI

Dejan Grujic

  • Anesthesiology Physician
  • Aspen, CO
National Provider Identifier
1972791705
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DR.0067523 Issued in CO
Practice address
401 Castle Creek Rd
Aspen, CO 81611-1159
Phone
(970) 925-1120
NPI assigned
Oct 5, 2007
Last updated
Apr 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X DR.0067523 CO Primary
Surgery Physician 208600000X 99999999 PA

Addresses

Primary practice location

401 Castle Creek Rd
Aspen, CO 81611-1159

Mailing address

323 Llandrillo Rd
Bala Cynwyd, PA 19004-2336

Other practice location 1

323 Llandrillo Rd
Bala Cynwyd, PA 19004-2336
Phone (666) 666-6666

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
I20220617000084 CO Practitioner - Anesthesiology 1153591110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspen Anesthesia, IncGroup PAC ID 7113065970, 13 clinicians

Practice addresses (Care Compare)

401 Castle Creek Rd
Aspen, CO 81611-1159
Phone (970) 925-1120

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99999999PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Anesthesia, Inc CurrentSince Jul 7, 2022 Accepting new patients

Locations

401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192

1450 E Valley Rd
Unit 202
Basalt, CO 81621
Phone (970) 384-6940

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1972791705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 LLANDRILLO RD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CASTLE CREEK RD",
            "city": "ASPEN",
            "state": "CO",
            "postal_code": "816111159",
            "telephone_number": "970-925-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 Llandrillo Rd",
            "address_purpose": "LOCATION",
            "city": "Bala Cynwyd",
            "state": "PA",
            "postal_code": "190042336",
            "country_code": "US",
            "telephone_number": "666-666-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUJIC",
        "first_name": "DEJAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-05",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR.0067523",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "99999999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aspen, CO

Sources for this page

Verify at the official NPI Registry.