NPIMap

Organization Active NPI

Colorado Surgical Service PC

Doing business as Surgical Specialists of Colorado

  • Surgery Physician
  • Wheat Ridge, CO
National Provider Identifier
1487260915
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
COLORADO SURGICAL SERVICE PC
Doing business as
Surgical Specialists of Colorado
Practice address
3455 Lutheran Pkwy Ste 290
Wheat Ridge, CO 80033-6034
Phone
(303) 467-1400
Fax
(303) 467-1467
NPI assigned
Sep 21, 2020
Last updated
Sep 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Authorized official

Name
Lars Ankersen
Title
Cof
Phone
(720) 996-0780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3455 Lutheran Pkwy Ste 290
Wheat Ridge, CO 80033-6034

Mailing address

4350 Wadsworth Blvd Ste 401
Wheat Ridge, CO 80033-4638
Phone (720) 996-0780

Other names 1

  • Surgical Specialists of Colorado Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304000186 CO Part B Supplier - Clinic/Group Practice 7416844311 Receives reassigned benefits from 20 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Basalt, CO; Golden, CO; Highlands Ranch, CO; Wheat Ridge, CO

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1487260915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 WADSWORTH BLVD STE 401",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334638",
            "telephone_number": "720-996-0780",
            "fax_number": "303-382-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 LUTHERAN PKWY STE 290",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336034",
            "telephone_number": "303-467-1400",
            "fax_number": "303-467-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SURGICAL SERVICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "ANKERSEN",
        "authorized_official_first_name": "LARS",
        "authorized_official_title_or_position": "COF",
        "authorized_official_telephone_number": "720-996-0780"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Specialists of Colorado",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.