MARIO J IMOLA MD NPI 1932101490

NPI Information

NPI: 1932101490
Provider Name: MARIO J IMOLA, MD
Classification: Otolaryngology - 207YS0123X
Entity Type: Individual

Specialization: Facial Plastic Surgery

PECOS Registration: Yes

Address:
3600 S LOGAN ST
SUITE 100
ENGLEWOOD, CO
ZIP 80113
Phone: (303) 839-7980
Get Directions

Mario J Imola, MD is a facial plastic surgery otolaryngology in Englewood, CO with 37 years of experience. The provider is an otolaryngologist who specializes in facial plastic surgery. Mario J Imola, MD NPI is 1932101490. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3600 S LOGAN ST
SUITE 100
ENGLEWOOD, CO
ZIP 80113-766
Phone: (303) 839-7980
Fax: (303) 839-7936

The NPI 1932101490 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/15/2005 and was last updated on 10/17/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207YS0123X	Otolaryngology	Facial Plastic Surgery	38335	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	841553144	OTHER	COLORADO	TAX ID
2	240007576	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	RAILROAD
3	117142900	MEDICAID	WYOMING
4	G11247	MEDICARE UPIN	COLORADO
5	37821	MEDICARE ID-TYPE UNSPECIFIED	COLORADO
6	95739831	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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