Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Anthony Richard Declusin, MD

Individual provider General Practice Physician · NPI 1669977997

Anthony Richard Declusin, MD is a Neurology in Longmont, Colorado. Graduated from Medical College of Wisconsin in 2018, 8 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Colorado.

Years since qualifying
8
Trained at
Medical College of Wisconsin
Licensed in
CO
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone: (720) 718-8070
Fax: (720) 494-3107
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence DR.0066615 (CO)
General Practice Physician Taxonomy 208D00000X · Licence DR.0066615 (CO)

Record details

NPI number1669977997
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 28, 2018
Last updated in NPPESJuly 6, 2023
Certification dateJuly 6, 2023
Mailing address1925 Mountain View Ave, Longmont, CO 80501-3128

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2018 (8 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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