ELLIS SAM FISHMAN (NPI# 1144335696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144335696 |
| Entity Type | Individual |
| Full Name | ELLIS SAM FISHMAN |
| Credential | MD |
| Practice Address |
3885 Upham St 100 Wheat Ridge CO 80033-4880 |
| Practice Telephone | 3037420108 |
| Practice Fax Number | 3037420690 |
| Mailing Telephone | 3037420108 |
| Mailing Fax Number | 3037420690 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2016-04-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
14519 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 1144335696 | 05 |
| Street Address |
3885 UPHAM ST 100 |
| City | WHEAT RIDGE |
| State | CO |
| Zip Code | 80033-4880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972504314 | Geoffery W.p. Clover | Internal Medicine | 3885 Upham St, Suite 200, Wheat Ridge, CO 80033-4880 | 2005-08-09 |
| 1285197962 | Thomas Sec | Nurse Practitioner | 3885 Upham St, Wheat Ridge, CO 80033-4880 | 2019-04-10 |
| 1881100394 | Amber R Mcdonald | Social Worker | 3885 Upham St, Wheat Ridge, CO 80033-4880 | 2017-12-19 |
| 1083888937 | Katherine Mirro Johnson | Internal Medicine | 3885 Upham St, Suite 200, Wheat Ridge, CO 80033-4880 | 2008-04-22 |
| 1780855247 | Laura O'bryan Coster | Internal Medicine | 3885 Upham St, Suite 200, Wheat Ridge, CO 80033-4880 | 2008-03-12 |
| 1629273321 | Amber Marie Noon | Internal Medicine | 3885 Upham St, Suite 200, Wheat Ridge, CO 80033-4880 | 2007-06-20 |
| 1154464766 | Brent Wieland | Internal Medicine | 3885 Upham St, Ste 200, Wheat Ridge, CO 80033-4880 | 2007-02-14 |
| 1063578516 | Sonali Hemachandra | Internal Medicine | 3885 Upham St, Suite 200, Wheat Ridge, CO 80033-4880 | 2006-12-29 |
| 1598828949 | Western Infectious Disease Consultants, P.C. | Internal Medicine | 3885 Upham St, Suite 200, Wheat Ridge, CO 80033-4880 | 2006-12-18 |
| 1649333006 | Western Infectious Disease Infusion Center, Inc | Internal Medicine | 3885 Upham St, Suite 200, Wheat Ridge, CO 80033-4880 | 2006-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154893915 | Bronwyn Hockersmith | Counselor | 3954 Yosemite St, Wheat Ridge, CO 80033 | 2018-12-18 |
| 1902392004 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 4891 Independence St Ste 285, Wheat Ridge, CO 80033 | 2018-07-02 |
| 1528586120 | Front Range Family Resource Center | Marriage & Family Therapist | 5181 Ward St Ste 201, Wheat Ridge, CO 80033 | 2017-09-03 |
| 1962920918 | Dianna Lee Cordero | Counselor | 4931 Garrison St., Apt 104, Wheat Ridge, CO 80033 | 2017-08-30 |
| 1396261525 | Lauren Faye Petasne | Nurse Practitioner | 7100 W 44th Ave Ste 101a, Wheat Ridge, CO 80033 | 2017-08-18 |
| 1558802421 | Elizabeth Ann Huddleston | Nurse Practitioner | 3400 N Lutheran Pkwy, Wheat Ridge, CO 80033 | 2017-03-13 |
| 1053777045 | Richard Kerry Brandow | Counselor | 16625 W 50th Ave., Golden, CO 80033 | 2016-01-07 |
| 1831562131 | Eternal Life Care Centers, LLC | Assisted Living Facility | 4370 Ingalls Street, Wheat Ridge, CO 80033 | 2015-11-09 |
| 1740663483 | Real Care, Inc. | Private Vehicle | 10200 West 44th Ave, Suite 200, Wheat Ridge, CO 80033 | 2015-06-30 |
| 1508254848 | Pamela June Weitzel | Midwife | 3555 Lutheran Parkway Suite 210, Wheat Ridge, CO 80033 | 2015-01-08 |
| Find all providers in zip 80033 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871623710 | Megan M Graeser | Internal Medicine | 10900 W 44th Ave Unit 200, Wheat Ridge, CO 80033-2742 | 2007-03-07 |
| 1477669323 | Geriatric & Family Medicine Associates, PC | Internal Medicine | 3885 Upham St, 100, Wheat Ridge, CO 80033-4880 | 2006-08-22 |
| 1275596652 | Jill Marie Sohayda | Internal Medicine | 3550 Lutheran Pkwy, G20, Wheat Ridge, CO 80033-6017 | 2006-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151934 | Geriatric Medicine Associates, PC | Internal Medicine | 500 W 144th Ave Ste 140, Westminster, CO 80023-9326 | 2020-10-15 |
| 1609241264 | Goodness Health, LLC | Internal Medicine | 6816 W 84th Cir Unit 36, Arvada, CO 80003-1139 | 2015-12-08 |
| 1932528247 | Ian Reynolds | Internal Medicine | 13001 E 17th Pl # P, Aurora, CO 80045-2570 | 2014-04-15 |
| 1801037726 | Elizabeth Suzanne Clarke | Internal Medicine | 301 W 6th Ave # Mc3251, Wellington E Webb Center for Primary Care, Denver, CO 80204-5182 | 2009-03-23 |
| 1528232402 | Shalom Park Professional Services LLC | Internal Medicine | 14800 E Belleview Drive, Aurora, CO 80015-2258 | 2008-04-22 |
| 1023297579 | Long Term Care & Rehab Consultants, LLC | Internal Medicine | 5792 Cole Ct, Arvada, CO 80002-1155 | 2007-11-01 |
| 1811176688 | Preferred Provider Services | Internal Medicine | 8200 S Quebec St Ste A3-313, Centennial, CO 80112-4411 | 2007-10-30 |
| 1821289752 | William A Solomon, Md, P.C. | Internal Medicine | 3140 S Peoria St # 266, Aurora, CO 80014-3178 | 2007-08-06 |
| 1124223847 | Pamela Tyrrell Md PC | Internal Medicine | 1305 Krameria St # H143, Denver, CO 80220-2743 | 2007-06-21 |
| 1962524942 | Fred Michael Feinsod | Internal Medicine | 9 Alta Vista Rd, Colorado Springs, CO 80906-4202 | 2007-04-03 |
| Find all providers with the same taxonomy | ||||
| City | WHEAT RIDGE |
| Zip Code | 80033 |
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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.