Edwin F. Dezoeten

MD | Pediatric Gastroenterology | Male

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Complete Profile:

Edwin F. Dezoeten basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Gastroenterology
Provider Name :	Edwin F. Dezoeten
Credential :	MD
Gender :	Male

Business Address:

Edwin F. Dezoeten address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	13123 East 16th Avenue, The Children's Hospital Aurora, CO, 80045-7106 United States
Phone Number :	720-777-1234

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1871701441
NPI Entity Type :	Individual
First Enrolment Date :	18 May, 2007
Last Updated On :	12 Aug, 2013

Medicare Participation:

Edwin F. Dezoeten participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	7416048418
Medicare Enrollment ID :	I20100907001113
Primary Specialty :	Gastroenterology
Medical School :	University Of Illinois College Of Med (chi/peor/rock/chm-urb)
Graduation Year :	2001
Accepts Medicare?	Yes. Edwin F. Dezoeten accepts medicare insurance.

Group Practice Association:

Edwin F. Dezoeten is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Edwin F. Dezoeten is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
University Physicians Incorporated	3476465667	2518	13123 E 16th Ave Children's Hospital Colorado Aurora, CO - 800457106 Ph: 7207771234	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Edwin F. Dezoeten are as mentioned. Primary taxonomy code for Edwin F. Dezoeten, MD is 2080P0206X (Pediatrics Pediatric Gastroenterology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0206X	Pediatrics Pediatric Gastroenterology	No	MD424151	PA
2080P0206X	Pediatrics Pediatric Gastroenterology	Yes	49029	CO

Legacy Identifiers:

Other legacy medical identifiers of Edwin F. Dezoeten such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
30484235	MEDICAID	CO

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	Po Box 110429 Aurora, CO, 80042-0429 United States
Phone Number :	303-493-7000

Business Location:

Patients can refer following map for directions to Edwin F. Dezoeten practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.