| Livenew, Co. | |
|
9800 Mt Pyramid Ct Ste 300 Englewood CO 80112-2667 | |
| (303) 269-4370 | |
| (303) 269-4371 |
| Full Name | Livenew, Co. |
|---|---|
| Speciality | Surgery |
| Location | 9800 Mt Pyramid Ct Ste 300, Englewood, Colorado |
| Authorized Official Name and Position | Joshua William Long (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3032694370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livenew, Co. 9695 S Yosemite St Ste 285 Lone Tree CO 80124-2890 Ph: (303) 269-4370 | Livenew, Co. 9800 Mt Pyramid Ct Ste 300 Englewood CO 80112-2667 Ph: (303) 269-4370 |
| NPI Number | 1336669076 |
|---|---|
| Provider Enumeration Date | 06/23/2017 |
| Last Update Date | 03/12/2021 |
| Certification Date | 03/12/2021 |
| Medicare PECOS PAC ID | 0648540724 |
|---|---|
| Medicare Enrollment ID | O20170721002720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336669076 | NPI | - | NPPES |
| DR.0051485 | Other | CO | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (NU) | Secondary |
| 208600000X | Surgery | DR.0051485 (Colorado) | Secondary |
| 208600000X | Surgery | (NU) | Primary |
| Provider Name | Joshua W Long |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922212729 PECOS PAC ID: 9638357296 Enrollment ID: I20120911000515 |
| Provider Name | Sujata Wagh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750444279 PECOS PAC ID: 8224042247 Enrollment ID: I20160309000799 |
| Provider Name | Tamra Dee Srianant |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063750719 PECOS PAC ID: 8325293053 Enrollment ID: I20201119001249 |
| Provider Name | Caitlin Lockhart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497428783 PECOS PAC ID: 1557745932 Enrollment ID: I20220902001335 |
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Healthone Clinic Services Medical Specialties LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 799 E Hampden Ave Ste 100, Englewood, CO 80113 Phone: 303-788-4052 |
Prana Internal Medicine PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3292 S Bannock St, Englewood, CO 80110 Phone: 303-761-1045 Fax: 303-761-1253 |
Brian R Bishop PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3601 S Clarkson St Ste 100, Englewood, CO 80113 Phone: 720-833-0400 Fax: 303-788-7437 |