| Rocky Mountain Neuropsychiatric Associates, P.c. | |
|
6160 Tutt Blvd Ste 100 Colorado Springs CO 80923-3503 | |
| (719) 473-2346 | |
| (719) 577-9627 |
| Full Name | Rocky Mountain Neuropsychiatric Associates, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6160 Tutt Blvd Ste 100, Colorado Springs, Colorado |
| Authorized Official Name and Position | Richard Marciniak (PRESIDENT) |
| Authorized Official Contact | 7194732346 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Neuropsychiatric Associates, P.c. 6160 Tutt Blvd Ste 100 Colorado Springs CO 80923-3503 Ph: (719) 473-2346 | Rocky Mountain Neuropsychiatric Associates, P.c. 6160 Tutt Blvd Ste 100 Colorado Springs CO 80923-3503 Ph: (719) 473-2346 |
| NPI Number | 1588606818 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 08/16/2023 |
| Certification Date | 08/16/2023 |
| Medicare PECOS PAC ID | 3375517568 |
|---|---|
| Medicare Enrollment ID | O20040824000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588606818 | NPI | - | NPPES |
| CJ6860 | Other | CO | RAIL ROAD MEDICARE |
| R0633762 | Other | CO | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Julie L Sanford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386686236 PECOS PAC ID: 0345214540 Enrollment ID: I20070919000824 |
| Provider Name | Kevin N Batterbee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427112572 PECOS PAC ID: 9032268016 Enrollment ID: I20090521000473 |
| Provider Name | Richard Dwight Marciniak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548202492 PECOS PAC ID: 2264406461 Enrollment ID: I20110216001194 |
| Provider Name | Vanessa J Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508977836 PECOS PAC ID: 9931325206 Enrollment ID: I20140722001631 |
| Provider Name | Cynthia Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710452750 PECOS PAC ID: 5991059040 Enrollment ID: I20181108002306 |
| Provider Name | Briana Tillman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619434545 PECOS PAC ID: 7315339363 Enrollment ID: I20220125000438 |
| Provider Name | Dawn Latrice Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962101006 PECOS PAC ID: 8729445994 Enrollment ID: I20230601003147 |
| Provider Name | Max Rubenstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417585159 PECOS PAC ID: 3173985298 Enrollment ID: I20230821003414 |
| Provider Name | Samuel Edward Polhemus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326624420 PECOS PAC ID: 6305209628 Enrollment ID: I20230901002841 |
| Provider Name | Tiffany Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285210245 PECOS PAC ID: 8729427885 Enrollment ID: I20240422003208 |
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