DR. JED JITSUGO TATSUYAMA (NPI# 1114960192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114960192 |
| Entity Type | Individual |
| Full Name | DR. JED JITSUGO TATSUYAMA |
| Credential | MD |
| Practice Address |
1619 N Greenwood St Suite 200 Pueblo CO 81003-2644 |
| Mailing Address |
1619 N Greenwood Street Suite 200 Pueblo CO 81003 |
| Practice Telephone | 7195431130 |
| Practice Fax Number | 7195612764 |
| Mailing Telephone | 7195431130 |
| Mailing Fax Number | 7195612764 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2008-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 41404 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 62287338 | 05 |
| Street Address |
1619 N GREENWOOD ST SUITE 200 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81003-2644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043206311 | Radiology Associates | Specialist | 1619 N Greenwood St, Suite 100, Pueblo, CO 81003-2644 | 2005-09-22 |
| 1437600608 | Diana Karnilaw | Nurse Practitioner | 1619 N Greenwood St, Suite 400, Pueblo, CO 81003-2644 | 2016-10-21 |
| 1629451091 | Rachel R Buck | Nurse Practitioner | 1619 N Greenwood St, Suite 208, Pueblo, CO 81003-2644 | 2015-07-03 |
| 1861808750 | Jamie Kathryn Rendler | Nurse Practitioner | 1619 N Greenwood St, Suite 208, Pueblo, CO 81003-2644 | 2014-07-11 |
| 1104181148 | Eric Andrew Lewis | Podiatrist | 1619 N Greenwood St, Suite 300, Pueblo, CO 81003-2644 | 2012-07-05 |
| 1144510660 | Sarah Elizabeth Bryant | Pediatrics | 1619 N Greenwood St, Suite 400, Pueblo, CO 81003-2644 | 2011-04-18 |
| 1043442791 | Steven Nafziger | Family Medicine | 1619 N Greenwood St, Suite 204, Pueblo, CO 81003-2644 | 2009-08-13 |
| 1841421344 | David Abbott | Radiology | 1619 N Greenwood St, Suite 103, Pueblo, CO 81003-2644 | 2009-07-31 |
| 1891923033 | Mark Edward Maurer | Podiatrist | 1619 N Greenwood St, Ste 300, Pueblo, CO 81003-2644 | 2009-06-25 |
| 1346400413 | Elizabeth Ehrhardt Md Prof LLC | Pediatrics | 1619 N Greenwood St, Ste 400, Pueblo, CO 81003-2644 | 2008-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042016 | Sunil Kumar | Student in an Organized Health Care Education/Training Program | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2020-04-21 |
| 1497382303 | Pueblo Family Dentistry Pllc | Dentist | 701 N Grand Avenue, Suite B, Pueblo, CO 81003 | 2020-03-23 |
| 1023654241 | Elmer A. Villalon, Dmd, LLC | Clinic/Center | 1225 North Main Street, #207, Pueblo, CO 81003 | 2019-11-22 |
| 1518434349 | Mariam Rahim | Internal Medicine | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-10-30 |
| 1003308222 | Julia Mcneice | Internal Medicine | Parkview Medial Center, Parkveiw Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-06-04 |
| 1689164857 | Jessica Sels | Internal Medicine | Parkview Medical Center Adult Medicine Clinic, 311 W 14th St, Pueblo, CO 81003 | 2018-05-14 |
| 1700313459 | Allison Vigil | Occupational Therapist | 1600 W. 24th St, Pueblo, CO 81003 | 2017-05-12 |
| 1245682020 | Paul S Bongat | Internal Medicine | 411 W. 14th St., Parkview Adult Medicine Clinic, Pueblo, CO 81003 | 2016-07-06 |
| 1013368596 | Daniel R Long | Internal Medicine | 411 West 14th Street, Pueblo, CO 81003 | 2016-06-27 |
| 1396195665 | Parkview Medical Center | General Acute Care Hospital | 411 W. 14th St, Pueblo, CO 81003 | 2016-06-17 |
| Find all providers in zip 81003 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356992606 | Kristie Lamotta | Family Medicine | 1600 N Grand Ave Ste 350, Pueblo, CO 81003-2729 | 2019-09-26 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1134484660 | Aparna Seetharama | Family Medicine | 1600 N. Grand Ave, Ste 260, Pueblo, CO 81003-2729 | 2012-07-11 |
| 1710275037 | Catholic Health Initiatives Colorado | Family Medicine | 916 Indiana Ave., Suite 120, Pueblo, CO 81004 | 2011-07-20 |
| 1124336169 | Timothy J Cawlfield, Md, Pllc | Family Medicine | 41 Montebello Rd Ste 210, Pueblo, CO 81001-1379 | 2010-09-23 |
| 1639308828 | Emma Iovane Stout | Family Medicine | 115 E. Riverwalk, Suite 200, Pueblo, CO 81003-2246 | 2009-07-08 |
| 1750510145 | Wendy Alejandra Girard | Family Medicine | 1925 East Orman Avenue, Suite A109, Pueblo, CO 81004 | 2009-07-07 |
| 1881839694 | Bryan A Hynes | Family Medicine | 415 N Grand Ave, Pueblo, CO 81003-3111 | 2008-12-08 |
| 1093988917 | Louise Mcdade | Family Medicine | 8 Carlile Pl, Pueblo, CO 81004-1213 | 2008-04-11 |
| 1891914693 | Prairie Medical Clinic Pllc | Family Medicine | 1726 S Prairie Ave, Pueblo, CO 81005-2253 | 2007-04-24 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.