Summit Medical Group of Colorado PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SUMMIT MEDICAL GROUP OF COLORADO PC

Practice address

1776 E Warm Springs Rd
208
Las Vegas, NV 89119-4676

Phone

(702) 932-8547

Fax

(702) 932-8586

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Malissa Thatcher

Title

Credentialing Person

Phone

(702) 932-8547

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer E Yee, APN

  • General Practice Registered Nurse
  • Las Vegas, NV
  • NPI 1952350092
  NPD (past)
• Rafael J Olivares, MD

  • Family Medicine Physician
  • Lakewood, CO
  • NPI 1093752206
  NPD (past)
• Evan Jay Pollack, MD

  • General Practice Physician
  • Aurora, CO
  • NPI 1588669626
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720015092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 E HAMPDEN AVE",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132780",
            "telephone_number": "303-689-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 E WARM SPRINGS RD",
            "address_2": "208",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194676",
            "telephone_number": "702-932-8547",
            "fax_number": "702-932-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP OF COLORADO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THATCHER",
        "authorized_official_first_name": "MALISSA",
        "authorized_official_title_or_position": "CREDENTIALING PERSON",
        "authorized_official_telephone_number": "702-932-8547"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27077527",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summit Integrated Injury
• Summit Ipo LLC
• Summit Medical Center
• Summit Medical Group (Abdou & Bacchus) PC
• Summit Medical Group LLC
• Summit Medical Holdings LLC
• Summit Mental Health
• Summit Primary Care & Wellness
• Summit Ridge Calderon PC
• Summit Specialty Physicians Inc

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.