| Craig Lelland Lastine, MD | |
|
2021 N 12th St, Grand Junction, CO 81501-2980 | |
| (970) 242-0920 | |
| (406) 587-1343 |
| Full Name | Craig Lelland Lastine |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 31 Years |
| Location | 2021 N 12th St, Grand Junction, Colorado |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891753497 | NPI | - | NPPES |
| 152524 | Medicaid | MT | |
| 06350003 | Medicaid | CO | |
| 0152507 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | DR.0044010 (Colorado) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Uch-memorial Health System | Colorado springs, CO | Hospital |
| San Luis Valley Health | Alamosa, CO | Hospital |
| Uchealth Pikes Peak Regional Hospital | Woodland park, CO | Hospital |
| Uchealth Grandview Hospital | Colorado springs, CO | Hospital |
| Rio Grande Hospital | Del norte, CO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Radiology And Imaging Consultants Pc | 1850298647 | 43 |
| Uchealth Imaging Services Llc | 5799021291 | 157 |
| Radiology And Imaging Consultants Pc | 1850298647 | 43 |
| Entity Name | Radiology & Imaging Consultants Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598700825 PECOS PAC ID: 1850298647 Enrollment ID: O20031218000702 |
| Entity Name | Uchealth Imaging Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396210902 PECOS PAC ID: 5799021291 Enrollment ID: O20190103002022 |
| Entity Name | Radiology Associates Of Albuquerque Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881666998 PECOS PAC ID: 2860304482 Enrollment ID: O20190926002793 |
| Mailing Address | Practice Location Address |
|---|---|
| Craig Lelland Lastine, MD Po Box 308, Montrose, CO 81402-0308 Ph: (970) 497-8416 | Craig Lelland Lastine, MD 2021 N 12th St, Grand Junction, CO 81501-2980 Ph: (970) 242-0920 |
Gayle Patrice Miller, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 2596 F Rd, Grand Junction, CO 81505 Phone: 970-254-3180 | |
Christopher O'hara Hampson, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2635 N 7th St, Grand Junction, CO 81501 Phone: 877-406-2916 Fax: 334-671-1696 | |
Corey Tait Eastham Sours, R.T. (R)(CT)(ARRT) Radiology Medicare: Not Enrolled in Medicare Practice Location: 2121 North Ave, Grand Junction, CO 81501 Phone: 970-242-0731 | |
John Terry Leever, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2021 N 12th St, Grand Junction, CO 81501 Phone: 970-256-6440 | |
Dr. Richard Eustis Fulton Iii, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1556 Wellington Ave, Grand Junction, CO 81501 Phone: 970-241-4406 | |
Dr. Justin M. Kaptuch, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2351 G Rd, Grand Junction, CO 81505 Phone: 970-644-3237 Fax: 970-644-3259 | |
John R Bumgarner, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2635 N 7th St, Grand Junction, CO 81501 Phone: 970-241-9729 |