NPIMap

Organization Active NPI

Colorado Pain Practice, LLC

Doing business as Colorado Pain Care

  • Pain Medicine (Anesthesiology) Physician
  • Lakewood, CO
National Provider Identifier
1487289096
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
COLORADO PAIN PRACTICE, LLC
Doing business as
Colorado Pain Care
Practice address
355 Union Blvd Ste 304
Lakewood, CO 80228-6516
Phone
(303) 984-4826
Fax
(303) 277-0714
NPI assigned
Mar 4, 2020
Last updated
Jun 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Robert Z Moghim, MDNPI 1245282862
Title
Owner/Physician
Phone
(303) 888-2219

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Pain Medicine (Anesthesiology) Physician 207LP2900X Primary

Addresses

Primary practice location

355 Union Blvd Ste 304
Lakewood, CO 80228-6516

Mailing address

1355 S Colorado Blvd Ste 700
Denver, CO 80222-3325
Phone (303) 277-0700

Other names 1

  • Colorado Pain Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170324000399 CO Part B Supplier - Clinic/Group Practice 6709161292 Receives reassigned benefits from 31 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Castle Rock, CO; Denver, CO; Lakewood, CO; Loveland, CO

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1583280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1487289096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 S COLORADO BLVD STE 700",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802223325",
            "telephone_number": "303-277-0700",
            "fax_number": "303-277-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 UNION BLVD STE 304",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802286516",
            "telephone_number": "303-984-4826",
            "fax_number": "303-277-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO PAIN PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-04",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "MOGHIM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "303-888-2219",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado Pain Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Colorado Pain Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.