Provider Demographics
NPI:1619953890
Name:BELLON, RICHARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:BELLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:SUITE 380
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113
Practice Address - Country:US
Practice Address - Phone:720-493-3345
Practice Address - Fax:720-874-4437
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD175852085R0202X
KS04-363492085R0202X
NE250872085R0202X
CO435522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1619953890Medicaid
NE84-059792913Medicaid
OK200424520AMedicaid
CO07724012Medicaid
MT1619953890Medicaid
NM62983521Medicaid
NEP00759816OtherRR MCR RIN
UT1679513196Medicaid
NE10025709000Medicaid
AZ175381Medicaid
KS200418270AMedicaid
WY121624400Medicaid
COP00247190OtherRR MEIDCARE RIA
COP00307174OtherRR MEDICARE MIC
COG68680Medicare UPIN
AZ175381Medicaid
MT1619953890Medicaid
NM62983521Medicaid
NENA1215029Medicare PIN
NENA2517033Medicare PIN
CO391741ZLJ3Medicare PIN
CO07724012Medicaid
COC801988Medicare PIN
KS200418270AMedicaid
WY121624400Medicaid
COCO304405Medicare PIN