COLORADO MEDICAL GROUP, PLLC (NPI# 1730796400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730796400 |
| Entity Type | Organization |
| Organization Name | COLORADO MEDICAL GROUP, PLLC |
| Other Organization Name | UNITED VEIN CENTERS OF LAKEWOOD, CO |
| Practice Address |
255 Union Blvd Ste 300 Lakewood CO 80228-1859 |
| Mailing Address |
3810 Northdale Blvd Ste 150 Tampa FL 33624-1871 |
| Practice Telephone | 8009916117 |
| Practice Fax Number | 8888128191 |
| Mailing Telephone | 8139611331 |
| Mailing Fax Number | 8888508316 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | LORI HEIN (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 8133799829 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLORADO MEDICAL GROUP, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| United Vein Centers of Lakewood, CO | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467069120 | Colorado Medical Group, Pllc | Surgery | 3665 John F Kennedy Pkwy Ste 200, Fort Collins, CO 80525-3152 | 2020-09-28 |
| 1053928234 | Colorado Medical Group, Pllc | Surgery | 6979 S Holly Cir Ste 125, Centennial, CO 80112-6267 | 2020-09-30 |
| 1811504582 | Colorado Medical Group, Pllc | Surgery | 1044 S 88th St Ste 105, Louisville, CO 80027-9418 | 2020-09-28 |
| 1356714638 | Colorado Medical Group, Pllc | Surgery | 6979 S Holly Cir Ste 125, Centennial, CO 80112-6267 | 2015-11-09 |
| Street Address |
255 UNION BLVD STE 300 |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80228-1859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003812942 | Joseph A Cocco | Surgery | 255 Union Blvd Ste 300, Lakewood, CO 80228-1859 | 2005-06-24 |
| 1427142181 | Sandra Lynn Bernard | Physician Assistant | 255 Union Blvd Ste 300, Lakewood, CO 80228-1859 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174083570 | Lindsey Mae Beverly | Physician Assistant | Medical Plaza 2, 11700 W 2nd Pl, #350, Lakewood, CO 80228 | 2019-03-21 |
| 1881119931 | Cory J Frazier | Nurse Practitioner | 11600 W. 2nd Pl, Lakewood, CO 80228 | 2017-08-10 |
| 1508213885 | Chelsea Tucker | Counselor | 12157 W Cedar Dr Ste 207, Lakewood, CO 80228 | 2016-05-17 |
| 1972963841 | Shastin Gerbracht | Counselor | 12055 W 2nd Pl, Ste 200, Lakewood, CO 80228 | 2016-03-04 |
| 1073983375 | Suzanne Phillips | Behavioral Analyst | 200 Union Blvd. Ste. 200, Lakewood, Co. 80228, Denver, CO 80228 | 2015-09-29 |
| 1700265667 | April Mearsha | Doula | 12977 W Cedar Dr, 2-305, Lakewood, CO 80228 | 2015-05-26 |
| 1306233713 | Caleb Hedberg | Internal Medicine | 165 S Union Blvd Ste 800, Lakewood, CO 80228 | 2015-04-23 |
| 1972996288 | David Lindsey Currie | Counselor | 12055 W 2nd Place, Jefferson Ctr for Mental Health, Lakewood, CO 80228 | 2015-03-11 |
| 1619365533 | Michelle Broberg II | Technician | 12055 West 2nd Plaza, Lakewood, CO 80228 | 2014-12-30 |
| 1750789012 | Kayla Morrison | Social Worker | 12005 W 2nd Place, Lakewood, CO 80228 | 2014-12-18 |
| Find all providers in zip 80228 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992341895 | Surgicalist of Ca PC | Surgery | 3300 E South St Ste 301a, Lakewood, CA 90805-4549 | 2019-11-26 |
| 1407929185 | Mahadevan G Krishnan, Md PC | Surgery | 609 River Ave, Lakewood, NJ 08701-5227 | 2006-11-17 |
| 1134563638 | Tri Star Orthopaedics | Surgery | 5220 Clark Ave, 100, Lakewood, CA 90712-2618 | 2013-04-26 |
| 1659628691 | Franciscan Medical Group | Surgery | 11307 Bridgeport Way Sw, Suite 210, Lakewood, WA 98499-3024 | 2012-08-09 |
| 1578866943 | Catholic Health Initiatives Colorado | Surgery | 11700 West 2nd Place, Suite 210b, Lakewood, CO 80228 | 2010-12-07 |
| 1699849620 | Mahadevan G Krishnan | Surgery | 609 River Ave, Lakewood, NJ 08701-5227 | 2006-11-20 |
| 1780657924 | Vascular Surgery Nw Ps | Surgery | 11311 Bridgeport Way Sw, #203, Lakewood, WA 98499 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831706506 | University Physicians, Incorporated | Surgery | 13100 E Colfax Ave Ste 70, Aurora, CO 80011-5517 | 2020-09-28 |
| 1376015297 | Molly Goldstein | Surgery | 1401 Court St, Pueblo, CO 81003-2715 | 2018-12-18 |
| 1437412723 | Junior Univers | Surgery | 2643 Patterson Rd Ste 401, Grand Junction, CO 81506-1937 | 2012-06-21 |
| 1275896508 | Dmitriy Rybitskiy | Surgery | 2222 N Nevada Ave Ste 5010, Colorado Springs, CO 80907-6865 | 2012-06-21 |
| 1518230333 | James Gilbert Chandler | Surgery | 3721 Mountain Laurel Pl, Boulder, CO 80304-0798 | 2012-02-10 |
| 1982982567 | Benson M Powell II | Surgery | 2572 Silver Oak Ct, Grand Junction, CO 81505-1091 | 2011-07-29 |
| 1205078912 | Rafael Demarchi Malgor | Surgery | 12631 E 17th Ave # Msc312, Aurora, CO 80045-2527 | 2009-03-26 |
| 1770610735 | Thomas F Rehring | Surgery | 2045 N Franklin St Fl 3, Denver, CO 80205-5437 | 2007-02-27 |
| 1770624298 | Charles O Brantigan Md | Surgery | 2253 Downing St, Denver, CO 80205-5234 | 2007-02-09 |
| 1588717656 | Cass William Conaway | Surgery | 721 19th St, Denver, CO 80202-2500 | 2007-01-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.