2ND Home Medical Center PLLC
Organization Active NPI Internal Medicine Physician · Denver, CO
NPI 1104790294 · NPPES record last updated Feb 5, 2026
Key facts
- NPI
- 1104790294
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- 2ND HOME MEDICAL CENTER PLLC
- Practice address
- 6880 E Evans Ave
Denver, CO 80224-2330 - Phone
- (303) 999-7763
- Fax
- (720) 367-5443
- NPI assigned
- Oct 1, 2025
- Organization subpart
- No
Authorized official
- Name
- Sami Mitri, DO
- Title
- Physician
- Phone
- (810) 240-7859
Practitioners 4
-
Christopher Johnson, D.O.
-
Sami Hannah Mitri, D.O.
-
Mousa Sawaged, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D2336109 | 2ND Home Medical Center PLLC | Certificate of waiver | Dec 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260127002788 | CO | Part B Supplier - Clinic/Group Practice | 6406334994 |
Receives reassigned benefits from 3 practitioners Practice locations: Denver, CO |
National Provider Directory
Locations
6880 E Evans Ave
Denver, CO 80224
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
6880 E Evans Ave
Denver, CO 80224-2330
Mailing address
3131 S Vaughn Way Ste 600
Aurora, CO 80014-3508
Phone (303) 999-7763
Other providers in Denver, CO
- 247 Home Health Care LTD
- 2875 W 33Rd LLC
- 290 South Monaco Parkway Operations LLC
- 2Health Foundation
- 2ND Home Community Living, LLC
- 2ND Home Pharmacy - Evans LLC
- 2Uplift Homecare LLC
- 2Uplift Homecare LLC
- 3 Doves Home Healthcare LLC
- 35TH Avenue Eneterprises P C
All providers in Denver, CO · Internal Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.