Basic Information
| Provider Information | |||||||||
| NPI: | 1851376966 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUMAR | ||||||||
| FirstName: | RAJIV | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 13772 DENVER WEST PKWY | ||||||||
| Address2: | BLDG#55 STE #100 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804013139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032796600 | ||||||||
| FaxNumber: | 3032799140 | ||||||||
| Practice Location | |||||||||
| Address1: | 13772 DENVER WEST PKWY | ||||||||
| Address2: | BLDG#55 STE #100 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804013139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032796600 | ||||||||
| FaxNumber: | 3032799140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2005 | ||||||||
| LastUpdateDate: | 01/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 43472 | CO | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 56878311 | 05 | CO | MEDICAID | 803092 | 01 | CO | MEDICARE LEGACY | OTHER | P00301879 | 01 | CO | RAILROAD MEDICARE | OTHER |