NPIMap

Organization Active NPI

South Denver Gastroenterology, PC

  • Gastroenterology Physician
  • Parker, CO
National Provider Identifier
1265038574
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SOUTH DENVER GASTROENTEROLOGY, PC
Practice address
9397 Crown Crest Blvd Ste 221
Parker, CO 80138-8576
Phone
(303) 788-8888
Fax
(866) 896-1158
NPI assigned
Dec 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Richard M Roman, MD
Title
President
Phone
(303) 788-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

9397 Crown Crest Blvd Ste 221
Parker, CO 80138-8576

Mailing address

9397 Crown Crest Blvd Ste 221
Parker, CO 80138-8576
Phone (303) 788-8888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317001558 CO Part B Supplier - Clinic/Group Practice 2062302508 Receives reassigned benefits from 57 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Castle Rock, CO; Englewood, CO; Lone Tree, CO; Parker, CO

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
South Denver Gastroenterology PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1265038574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9397 CROWN CREST BLVD STE 221",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388576",
            "telephone_number": "303-788-8888",
            "fax_number": "866-896-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9397 CROWN CREST BLVD STE 221",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388576",
            "telephone_number": "303-788-8888",
            "fax_number": "866-896-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DENVER GASTROENTEROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-10",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-788-8888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.