Provider Demographics
NPI:1023237633
Name:COLORADO FAMILY MEDICINE
Entity type:Organization
Organization Name:COLORADO FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANTINE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:TSAMASFYROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-322-2005
Mailing Address - Street 1:128 STEELE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5218
Mailing Address - Country:US
Mailing Address - Phone:303-322-2005
Mailing Address - Fax:
Practice Address - Street 1:128 STEELE ST STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5218
Practice Address - Country:US
Practice Address - Phone:303-322-2005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17165207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1114989332OtherNPI
CO17165OtherLICENSE
CO01171651Medicaid
CO04009676Medicaid
CO04009676Medicaid
COCE5718Medicare ID - Type UnspecifiedINDIVIDUAL
CO04009676Medicaid
CO01171651Medicaid