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Individual provider Active NPI

Nermin Imsirovic

  • Surgical Physician Assistant
  • Littleton, CO
National Provider Identifier
1538413398
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3580 Issued in CO
Practice address
7780 S Broadway Ste 350
Littleton, CO 80122-2641
Phone
(720) 638-7500
Fax
(720) 583-6770
NPI assigned
Nov 1, 2012
Last updated
Apr 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3580 CO
Medical Physician Assistant 363AM0700X 3580 CO
Surgical Physician Assistant 363AS0400X 3580 CO Primary

Addresses

Primary practice location

7780 S Broadway Ste 350
Littleton, CO 80122-2641

Mailing address

PO Box 5693
Denver, CO 80217-5693
Phone (303) 306-7783

Other practice location 1

750 Wellington Ave
Suite 3A
Grand Junction, CO 81501-6132
Phone (970) 298-3188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130131000015 CO Practitioner - Physician Assistant 9234383142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527

11650 W 2ND PL
Lakewood, CO 80228-1527

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3580COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2021 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2021 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

11750 W 2nd Pl
Ste 255
Lakewood, CO 80228
Phone (303) 629-5600

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1538413398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5693",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175693",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7780 S BROADWAY STE 350",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222641",
            "telephone_number": "720-638-7500",
            "fax_number": "720-583-6770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Wellington Ave",
            "address_2": "Suite 3A",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815016132",
            "country_code": "US",
            "telephone_number": "970-298-3188",
            "fax_number": "970-298-3190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMSIROVIC",
        "first_name": "NERMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-01",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3580",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3580",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "3580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.