NPIMap

Organization Active NPI

Digestive Diseases Specialists of Colorado,LLC

  • Gastroenterology Physician
  • Pueblo, CO
National Provider Identifier
1033135330
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
DIGESTIVE DISEASES SPECIALISTS OF COLORADO,LLC
Practice address
1600 N Grand Ave
Suite 440
Pueblo, CO 81003-2700
Phone
(719) 543-3500
Fax
(719) 543-3504
NPI assigned
Jul 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Atul Vahil, MD
Title
President/Owner
Phone
(719) 543-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

1600 N Grand Ave
Suite 440
Pueblo, CO 81003-2700

Mailing address

1600 N Grand Ave
Suite 440
Pueblo, CO 81003-2700
Phone (719) 543-3500

Other identifiers 1

IdentifierTypeStateIssuer
85954764MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041115001261 CO Part B Supplier - Clinic/Group Practice 8527022060 Receives reassigned benefits from 8 practitioners
Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory

Locations

1318 Court St
Pueblo, CO 81003
Phone (719) 543-3500

1600 N Grand Ave
Ste 120
Pueblo, CO 81003
Phone (719) 545-9292

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033135330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 440",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032700",
            "telephone_number": "719-543-3500",
            "fax_number": "719-543-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 440",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032700",
            "telephone_number": "719-543-3500",
            "fax_number": "719-543-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASES SPECIALISTS OF COLORADO,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAHIL",
        "authorized_official_first_name": "ATUL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "719-543-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85954764",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.