Ncap Imh, LLC

Organization Active NPI Anesthesiology Physician · Fort Collins, CO

NPI 1093478075 · NPPES record last updated Oct 18, 2021

Key facts

NPI
1093478075
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
NCAP IMH, LLC
Practice address
3702 Automation Way Ste 103
Fort Collins, CO 80525-5738
Phone
(970) 922-3626
NPI assigned
Oct 18, 2021
Organization subpart
No

Authorized official

Name
Julie Lease
Title
Director Finance and Accounting
Phone
(970) 922-3626

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20211230000402 WY Part B Supplier - Clinic/Group Practice 2365833340 Receives reassigned benefits from 31 practitioners
Practice locations: Laramie, WY

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207L00000X Yes

Addresses

Primary practice location

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738

Mailing address

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738

Other providers in Fort Collins, CO

All providers in Fort Collins, CO · Anesthesiology Physician in Colorado

Sources for this page

Verify at the official NPI Registry.