NPIMap

Organization Active NPI

Colorado Pain Practice, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Denver, CO
National Provider Identifier
1154846939
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
COLORADO PAIN PRACTICE, PLLC
Practice address
2696 S Colorado Blvd Ste 100
Denver, CO 80222
Phone
(303) 963-9182
NPI assigned
Aug 14, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Robert Moghim, MDNPI 1245282862
Title
Physician Owner
Phone
(303) 888-2219

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

2696 S Colorado Blvd Ste 100
Denver, CO 80222

Mailing address

1355 S Colorado Blvd Ste 700
Denver, CO 80222-3325
Phone (303) 963-9182

Other names 1

  • Colorado Pain Practice, PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170324000399 CO Part B Supplier - Clinic/Group Practice 6709161292 Receives reassigned benefits from 31 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Castle Rock, CO; Denver, CO; Lakewood, CO; Loveland, CO
O20170821000678 CO DME Supplier - Physician - Interventional Pain Management 6709161292 Practice locations: Denver, CO

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2696 S Colorado Blvd
Ste 240
Denver, CO 80222
Phone (210) 213-4444

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154846939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 S COLORADO BLVD STE 700",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802223325",
            "telephone_number": "303-963-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2696 S COLORADO BLVD STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80222",
            "telephone_number": "303-963-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO PAIN PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MOGHIM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "303-888-2219",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado Pain Practice, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.