| Dr Lori M Dirusso, MD | |
|
4803 Ward Rd, Wheat Ridge, CO 80033-1902 | |
| (303) 338-4545 | |
| Not Available |
| Full Name | Dr Lori M Dirusso |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 4803 Ward Rd, Wheat Ridge, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033246079 | NPI | - | NPPES |
| 55085717 | Medicaid | CO | |
| 015613 | Other | KAISER-COMMERCIAL NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 42196 (Colorado) | Primary |
| Entity Name | Colorado Permanente Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760599724 PECOS PAC ID: 1254238454 Enrollment ID: O20031216000640 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lori M Dirusso, MD 10350 E Dakota Ave, Denver, CO 80247-1314 Ph: (303) 338-3382 | Dr Lori M Dirusso, MD 4803 Ward Rd, Wheat Ridge, CO 80033-1902 Ph: (303) 338-4545 |
Larissa Ann Applegate, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3555 Lutheran Pkwy, Suite 200, Wheat Ridge, CO 80033 Phone: 720-284-3700 | |
Dr. Susan M. Fudge-erickson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3555 Lutheran Parkway, Suite 200, Wheat Ridge, CO 80033 Phone: 720-284-3700 Fax: 303-467-0525 | |
Barbara Elizabeth Barringer, PAC Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3655 Lutheran Pkwy, Suite 300, Wheat Ridge, CO 80033 Phone: 720-284-3700 Fax: 303-467-0525 | |
Dr. Katya Bograd, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4803 Ward Rd, Wheat Ridge, CO 80033 Phone: 303-338-4545 | |
Lance J Lazatin, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6055 W 46th Ave, Suite A, Wheat Ridge, CO 80033 Phone: 303-423-8017 Fax: 720-639-6894 | |
Dr. Cynthia L. Frederick, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3555 Lutheran Parkway, Suite 200, Wheat Ridge, CO 80033 Phone: 720-284-3700 Fax: 303-467-0525 |