Provider Demographics
NPI:1710069091
Name:ORTHOPAEDIC ASSOCIATES
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES
Other - Org Name:ORTHOPEDIC ASSOCIATES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEB
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-321-6600
Mailing Address - Street 1:4700 E. HALE PKWY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4045
Mailing Address - Country:US
Mailing Address - Phone:303-321-6600
Mailing Address - Fax:303-321-8814
Practice Address - Street 1:4700 E. HALE PKWY
Practice Address - Street 2:SUITE 550
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4045
Practice Address - Country:US
Practice Address - Phone:303-321-6600
Practice Address - Fax:303-321-8814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO87853051Medicaid
COC379008Medicare PIN
CO3913510001Medicare NSC