Advanced Urology, PLLC
Organization Active NPI Urology Physician · Longmont, CO
NPI 1629628201 · NPPES record last updated Mar 8, 2025
Key facts
- NPI
- 1629628201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- Legal business name
- ADVANCED UROLOGY, PLLC
- Practice address
- 2030 Mountain View Ave Ste 420
Longmont, CO 80501-3182 - Phone
- (303) 776-9400
- NPI assigned
- Sep 16, 2019
- Organization subpart
- No
Authorized official
- Name
- Emily Simpson
- Title
- Provider Enrollment Manager
- Phone
- (720) 381-2805
Other NPIs on the same Medicare enrollment 16
Corporate family (same tax ID) 12
Practitioners 3
-
Geoff Tyler Ledgerwood, M.D.
-
Gordon McLennan, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031120000238 | CO | Part B Supplier - Clinic/Group Practice | 2365346558 |
Receives reassigned benefits from 92 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wheat Ridge, CO; Westminster, CO; Superior, CO; Louisville, CO; Castle Rock, CO; Longmont, CO; Lone Tree, CO; Lakewood, CO… |
National Provider Directory
- Tax ID family
- Advanced Urology PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | Yes |
Addresses
Primary practice location
2030 Mountain View Ave Ste 420
Longmont, CO 80501-3182
Mailing address
10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (443) 738-2889
Other providers in Longmont, CO
- Jillian Elizabeth Adkins
- Ma. Grace P Adler
- Mary C Adler
- Adrienne M. Hedrick, DDS,PC
- Advanced Neurology of Colorado, LLC
- Advanced Vision Surgery Center LLC
- Affinity Home Health Care
- Affirmative Care, P.C.
- After Baby Care Doula
- Shahbaz Ahmad Afzal
All providers in Longmont, CO · Urology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.