Organization Active NPI

Facial Plastic Surgery Center of Colorado Springs, PC

  • Plastic Surgery Physician
  • Colorado Springs, CO
National Provider Identifier
1386245348
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
FACIAL PLASTIC SURGERY CENTER OF COLORADO SPRINGS, PC
Practice address
3030 N Circle Dr
Colorado Springs, CO 80909-1177
Phone
(719) 632-5020
Fax
(719) 520-5488
NPI assigned
Nov 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Authorized official

Name
Thomas Andrew Dalsaso, MD
Title
Owner
Phone
(719) 632-5020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

3030 N Circle Dr
Colorado Springs, CO 80909-1177

Mailing address

6 Elm Ave
Colorado Springs, CO 80906-3130
Phone (706) 632-7429

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040430001190 CO Part B Supplier - Clinic/Group Practice 0749278653 Receives reassigned benefits from 1 practitioner
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colorado Springs, CO; Woodland Park, CO

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Facial Plastic Surgery Center of Colorado Springs PC4 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.

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1386245348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ELM AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063130",
            "telephone_number": "706-632-7429",
            "fax_number": "970-342-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 N CIRCLE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091177",
            "telephone_number": "719-632-5020",
            "fax_number": "719-520-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL PLASTIC SURGERY CENTER OF COLORADO SPRINGS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "DALSASO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-632-5020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.