MEDICARE: DR. RAYMOND ALAN MENCINI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	25917	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00212100	OTHER	CO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831158468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND ALAN MENCINI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 911057
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80291-1057
Country	:	US
Telephone Number	:	888-269-7001
Fax Number	:	303-764-6640

Provider Business Practice Location Address
First Line	:	11700 W 2ND PL STE 100
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-1707
Country	:	US
Telephone Number	:	720-321-8358
Fax Number	:	720-321-8231

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	04/18/2018

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