Organization Active NPI

Lone Tree Surgical Associates

  • Surgery Physician
  • Lone Tree, CO
National Provider Identifier
1205934791
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LONE TREE SURGICAL ASSOCIATES
Practice address
10099 Ridgegate Pkwy Ste 490
Lone Tree, CO 80124-5537
Phone
(303) 766-0357
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Naveed H Ismail, M.D.NPI 1427166842
Title
President
Phone
(303) 766-0357

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

10099 Ridgegate Pkwy Ste 490
Lone Tree, CO 80124-5537

Mailing address

PO Box 17402
Denver, CO 80217-0402

Other identifiers 1

IdentifierTypeStateIssuer
27489248MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000101 CO Part B Supplier - Clinic/Group Practice 9830185412 Receives reassigned benefits from 1 practitioner
Practice locations: Lone Tree, CO

National Provider Directory

National Provider Directory

Locations

10103 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (303) 225-8120

Practitioners & affiliated clinicians

Practitioners 1

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1205934791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17402",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802170402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10099 RIDGEGATE PKWY STE 490",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245537",
            "telephone_number": "303-766-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE TREE SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "ISMAIL",
        "authorized_official_first_name": "NAVEED",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-766-0357",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27489248",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.