MEDICARE: PODIATRY ASSOCIATES, INC

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	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

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

General Provider Information

NPI Number	:	1891158952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PODIATRY ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	7505 VILLAGE SQUARE DR
Second Line	:	# 101
City	:	CASTLE PINES
State	:	CO
Zip	:	80108-3692
Country	:	US
Telephone Number	:	303-805-5156
Fax Number	:	303-805-5157

Provider Business Practice Location Address
First Line	:	300 S JACKSON ST STE 310
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-3134
Country	:	US
Telephone Number	:	303-805-5156
Fax Number	:	303-805-5157

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. CYNTHIA CLASSEN
Credential	:	DPM
Telephone Number	:	303-805-5156

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	07/02/2021

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