NPIMap

Organization Active NPI

Rural Physicians Group - Pannu PLLC

  • Hospitalist Physician
  • Brush, CO
National Provider Identifier
1194306340
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
RURAL PHYSICIANS GROUP - PANNU PLLC
Practice address
2400 Edison St
Brush, CO 80723-1640
Phone
(303) 390-1924
NPI assigned
Apr 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Authorized official

Name
Sukhbir S Pannu
Title
Ceo/ Owner
Phone
(702) 933-3266

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

2400 Edison St
Brush, CO 80723-1640

Mailing address

5575 DTC Pkwy Ste 225
Greenwood Village, CO 80111-3073
Phone (303) 390-1924

Other identifiers 1

IdentifierTypeStateIssuer
9000157846MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141017001015 CO Part B Supplier - Clinic/Group Practice 0345467486 Receives reassigned benefits from 71 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sterling, CO; Canon City, CO; Rifle, CO; Pueblo, CO; Leadville, CO; Delta, CO; Cortez, CO; Colorado Springs, CO…

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Rural Physicians Group - Pannu PLLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1194306340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 DTC PKWY STE 225",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113073",
            "telephone_number": "303-390-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 EDISON ST",
            "city": "BRUSH",
            "state": "CO",
            "postal_code": "807231640",
            "telephone_number": "303-390-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL PHYSICIANS GROUP - PANNU PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "PANNU",
        "authorized_official_first_name": "SUKHBIR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO/ OWNER",
        "authorized_official_telephone_number": "702-933-3266"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000157846",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brush, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.