Provider Demographics
NPI:1013111970
Name:PODIATRY ASSOCIATES, INC
Entity type:Organization
Organization Name:PODIATRY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:OASE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-805-5156
Mailing Address - Street 1:7505 VILLAGE SQUARE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-3693
Mailing Address - Country:US
Mailing Address - Phone:303-805-5156
Mailing Address - Fax:303-805-5157
Practice Address - Street 1:2727 BRYANT ST STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4170
Practice Address - Country:US
Practice Address - Phone:720-855-9214
Practice Address - Fax:720-855-9291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO430213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01004308Medicaid
COCA1103Medicare PIN
COU03326Medicare UPIN
CO01004308Medicaid