Organization Active NPI

Surgone, PC

  • Colon & Rectal Surgery Physician
  • Lone Tree, CO
National Provider Identifier
1447700661
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
SURGONE, PC
Practice address
10103 Ridgegate Pkwy Ste 208
Lone Tree, CO 80124-5525
Phone
(303) 535-5350
Fax
(303) 535-5353
NPI assigned
Oct 12, 2016
Last updated
Nov 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Authorized official

Name
Shelby Uhernik, MBA
Title
Chief Executive Officer
Phone
(303) 957-1310

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU
Colon & Rectal Surgery Physician 208C00000X NU Primary

Addresses

Primary practice location

10103 Ridgegate Pkwy Ste 208
Lone Tree, CO 80124-5525

Mailing address

8490 E Crescent Pkwy Ste 380
Greenwood Village, CO 80111-2815
Phone (303) 957-1310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000709 CO Part B Supplier - Clinic/Group Practice 9032002985 Receives reassigned benefits from 41 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Englewood, CO; Lone Tree, CO; Greenwood Village, CO; Lafayette, CO; Littleton, CO; Thornton, CO; Edwards, CO; Denver, CO…

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Surgone20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1447700661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8490 E CRESCENT PKWY STE 380",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112815",
            "telephone_number": "303-957-1310",
            "fax_number": "303-761-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10103 RIDGEGATE PKWY STE 208",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245525",
            "telephone_number": "303-535-5350",
            "fax_number": "303-535-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGONE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A",
        "authorized_official_last_name": "UHERNIK",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "303-957-1310",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 1, 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.