Provider Demographics
NPI:1558764407
Name:AURORA PEDIATRIC ASSOCIATES, LLP
Entity Type:Organization
Organization Name:AURORA PEDIATRIC ASSOCIATES, LLP
Other - Org Name:ADVANCED PEDIATRIC ASSOCIATES, LLP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-699-6200
Mailing Address - Street 1:3300 S PARKER RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3518
Mailing Address - Country:US
Mailing Address - Phone:303-699-6200
Mailing Address - Fax:720-974-7175
Practice Address - Street 1:1300 S POTOMAC ST
Practice Address - Street 2:SUITE 156
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-6166
Practice Address - Country:US
Practice Address - Phone:303-699-6200
Practice Address - Fax:720-974-7175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44225208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO42757703Medicaid