Provider Demographics
NPI:1831158468
Name:MENCINI, RAYMOND ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:ALAN
Last Name:MENCINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911057
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1057
Mailing Address - Country:US
Mailing Address - Phone:888-269-7001
Mailing Address - Fax:303-764-6640
Practice Address - Street 1:11700 W 2ND PL STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1707
Practice Address - Country:US
Practice Address - Phone:720-321-8358
Practice Address - Fax:720-321-8231
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO259172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00212100OtherRAILROAD MEDICARE
CO01259175Medicaid
COP00212100OtherRAILROAD MEDICARE
COE23268Medicare UPIN
COCR6058Medicare PIN
COC807305Medicare PIN