Surgical Specialists of Centennial

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA-0001715 Issued in CO

Legal business name

SURGICAL SPECIALISTS OF CENTENNIAL

Practice address

5380 Autumn Dr
Greenwood Village, CO 80111-3424

Phone

(720) 974-2506

NPI assigned

Jul 26, 2016

Last updated

Jul 26, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Zaki Ibrahim, M.D.

Title

Owner/Physician

Phone

(720) 974-2506

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1447703558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4446",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801341451",
            "telephone_number": "720-974-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 AUTUMN DR",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113424",
            "telephone_number": "720-974-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALISTS OF CENTENNIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "ZAKI",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "720-974-2506",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA-0001715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suraj Sunder, MD
• Claire Sunderland, CF-SLP
• Mary Sundland, RN
• Joiesah Marie Uy Sunga, CAA
• Haley Sunshine
• Surgone, PC
• Surgone, PC
• Surgone, PC
• Carlie L Sutherland, MS CCC SLP
• Brittan Shea Sutphin

• Surgical Physician Assistant in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.