Provider Demographics
| NPI: | 1962461889 |
|---|---|
| Name: | UNIVERSITY PHYSICIANS INCORPORATED |
| Entity type: | Organization |
| Organization Name: | UNIVERSITY PHYSICIANS INCORPORATED |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ASSOCIATE COMPLIANCE OFFICER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | LISA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | DONAHUE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 303-493-7300 |
| Mailing Address - Street 1: | PO BOX 110429 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | AURORA |
| Mailing Address - State: | CO |
| Mailing Address - Zip Code: | 80042-0429 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 303-493-7000 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 12605 E 16TH AVE |
| Practice Address - Street 2: | UNIVERSITY OF COLORADO HOSPITAL |
| Practice Address - City: | AURORA |
| Practice Address - State: | CO |
| Practice Address - Zip Code: | 80045-5701 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 303-493-7000 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-03-20 |
| Last Update Date: | 2025-06-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| CO | 04200085 | Medicaid | |
| CO | 04200085 | Medicaid |