Provider Demographics
NPI:1942261870
Name:KASKE, TERESE I (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESE
Middle Name:I
Last Name:KASKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 E GEDDES AVE
Mailing Address - Street 2:NO 200
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:NO 102
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:303-761-6322
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO330012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025709000Medicaid
MI104686230Medicaid
WY1942261870Medicaid
NE84059792913Medicaid
CO01330018Medicaid
KS200425190AMedicaid
KS200425190AMedicaid
CO01330018Medicaid
COC211768Medicare PIN
COC22034Medicare PIN
NECO306527Medicare PIN
KS111257007Medicare PIN
CO300090367Medicare PIN
CO300090378Medicare PIN
COCW4478Medicare PIN
NE84059792913Medicaid