NPIMap

Organization Active NPI

Colorado Urologic Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Superior, CO
National Provider Identifier
1376155440
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
COLORADO UROLOGIC SURGERY CENTER LLC
Practice address
3 Superior Dr Ste 301
Superior, CO 80027-8655
Phone
(443) 738-2889
NPI assigned
Aug 20, 2020
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Christopher Hartshorn
Title
Officer/Authorized Official
Phone
(314) 800-2017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3 Superior Dr Ste 301
Superior, CO 80027-8655

Mailing address

14201 Dallas Pkwy
Dallas, TX 75254-2916
Phone (469) 872-4706

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201104000496 CO Part B Supplier - Ambulatory Surgical Center 7416367388 Practice locations: Superior, CO

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Colorado Urologic Surgery CenterCCN 06C0001185
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2209263Colorado Urologic Surgery Center, LLC3 Superior, Suite 301, Superior, CO 80027Certificate of waiverJan 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10535 Park Meadows Blvd
Ste 101
Lone Tree, CO 80124

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1376155440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 DALLAS PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542916",
            "telephone_number": "469-872-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SUPERIOR DR STE 301",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800278655",
            "telephone_number": "443-738-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO UROLOGIC SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-20",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "HARTSHORN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "314-800-2017"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Superior, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.