South Denver Physicians PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

46797 Issued in CO

Legal business name

SOUTH DENVER PHYSICIANS PLLC

Practice address

13111 E Briarwood Ave
#370
Centennial, CO 80112

Phone

(720) 441-4410

Fax

(888) 474-7158

NPI assigned

May 3, 2013

Organization subpart

No

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

Authorized official

Name

Dmitriy I Pales, DONPI 1548282700

Title

Sole Member

Phone

(720) 441-4410

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Dmitriy I Pales, DO

  • Hospitalist Physician
  • Centennial, CO
  • NPI 1548282700

  Internal Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Elina V Pales, DO

  • Neurology Physician
  • Centennial, CO
  • NPI 1386746949
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1124463161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13111 E BRIARWOOD AVE",
            "address_2": "SUITE #370",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123930",
            "telephone_number": "720-441-4410",
            "fax_number": "888-474-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 E BRIARWOOD AVE",
            "address_2": "#370",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80112",
            "telephone_number": "720-441-4410",
            "fax_number": "888-474-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DENVER PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "PALES",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "720-441-4410",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "46797",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "47080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148761",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Sotwick, BCBA
• Sound Bites Speech & Feeding Therapy
• Sound Sleep Care LLC
• Sounds Like This LLC
• Rachel Sours
• South Denver Psychotherapy LLC
• South Marion Manor Cares LLC
• South Metro - Cunningham Fire Rescue Authority
• South Metro Fire Rescue
• South Metro Fire Rescue Fire Protection District

• Internal Medicine Physician in Centennial, CO
• Providers in Centennial, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.