Provider Demographics
NPI:1962513309
Name:YOST, RAYMOND V (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:V
Last Name:YOST
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 1:5455 LANDMARK PL UNIT 806
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1955
Mailing Address - Country:US
Mailing Address - Phone:303-694-1190
Mailing Address - Fax:
Practice Address - Street 1:1746 COLE BLVD
Practice Address - Street 2:STE 150
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3208
Practice Address - Country:US
Practice Address - Phone:303-914-8800
Practice Address - Fax:303-716-3777
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO189132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01189133Medicaid
CO023817OtherKAISER COMMERCIAL NUMBER
CO33987777Medicaid
CO330000YK5YMedicare PIN
CO01189133Medicaid
COCH6768Medicare PIN
COD23520Medicare UPIN
COC803986Medicare PIN
CO023817OtherKAISER COMMERCIAL NUMBER