Provider Demographics
NPI:1639220221
Name:ROCKY MOUNTAIN CARDIOVASCULAR SURGEONS, P.C
Entity type:Organization
Organization Name:ROCKY MOUNTAIN CARDIOVASCULAR SURGEONS, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE/BUSINESS MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-695-1313
Mailing Address - Street 1:1455 SO POTOMAC STREET
Mailing Address - Street 2:SUITE 211
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4502
Mailing Address - Country:US
Mailing Address - Phone:303-695-1313
Mailing Address - Fax:303-695-5121
Practice Address - Street 1:1455 SO POTOMAC STREET
Practice Address - Street 2:SUITE 211
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4502
Practice Address - Country:US
Practice Address - Phone:303-695-1313
Practice Address - Fax:303-695-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO218172086S0129X, 207RI0011X, 207RC0001X, 207RC0000X, 208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04009395Medicaid
COCA1808Medicare ID - Type Unspecified