Lutheran Campus ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LUTHERAN CAMPUS ASC LLC

Practice address

12905 W 40TH Ave Ste 100
Golden, CO 80401-2791

Phone

(303) 301-7700

Fax

(303) 301-7701

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Decker

Title

Chief Administrative Officer

Phone

(303) 301-7705

Specialties & licenses 1

Addresses

Other names 1

• The Surgery Center at Lutheran Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Listed as

Lutheran Campus ASCCCN 06C0001113

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 3

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

• Colorado Pain and Rehab Professional LLC

  • Physical Medicine & Rehabilitation Physician
  • Wheat Ridge, CO
  • NPI 1285679829

  Member Of

  NPD member
• Colorado Surgical Service PC

  • Surgery Physician
  • Golden, CO
  • NPI 1679602593

  Member Of

  NPD member
• Sisters of Charity of Leavenworth Health System Inc

  • Institutional Pharmacy
  • Wheat Ridge, CO
  • NPI 1629515028

  Member Of

  NPD member

Locations

Practitioners 2

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

• Audrey Krajec

  • Registered Nurse
  • Golden, CO
  • NPI 1326857079
  NPD
• Fredric Zimmerman, DO

  • Physical Medicine & Rehabilitation Physician
  • Wheat Ridge, CO
  • NPI 1851322218
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1124086608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12905 W 40TH AVE STE 100",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804012791",
            "telephone_number": "303-301-7700",
            "fax_number": "303-301-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12905 W 40TH AVE STE 100",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804012791",
            "telephone_number": "303-301-7700",
            "fax_number": "303-301-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN CAMPUS ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "303-301-7705"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Surgery Center at Lutheran",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Lynn Loyd, MASTERS STUDENT
• Megan Luebke, M.S.
• Daneen Ann Luna, P.T.
• Emma Lundien, O.D.
• Rebekah Ann Lurtz, PTA
• Ryan Davis Lutz, MD
• Robert Wiliam Lyles, PT, DPT, ATC
• Amy Lynch
• Jennifer Marie Lyng, PT, DPT, ATC, CSCS
• Maeve Lyons, PA

• All providers in Golden, CO
• Ambulatory Surgical Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.