NPIMap

Organization Active NPI

Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Lakewood, CO
National Provider Identifier
1720614217
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
USACS OF COLORADO INC
Practice address
11600 W 2ND PL
Lakewood, CO 80228-1527
Phone
(330) 493-4443
NPI assigned
Mar 17, 2020
Last updated
Mar 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Authorized official

Name
Dominic BagnoliNPI 1659439453
Title
Board Director
Phone
(330) 493-4443

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

11600 W 2ND PL
Lakewood, CO 80228-1527

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040130000439 CO Part B Supplier - Clinic/Group Practice 4981507571 Receives reassigned benefits from 628 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Englewood, CO; Littleton, CO; Fort Morgan, CO; Frisco, CO; Grand Junction, CO; Highlands Ranch, CO; Lakewood, CO; Longmont, CO…
O20251024000039 OK Part B Supplier - Clinic/Group Practice 4981507571 Receives reassigned benefits from 1 practitioner
Practice locations: Tulsa, OK

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory

Locations

9670 W Coal Mine Ave
Ste 100
Littleton, CO 80123
Phone (303) 725-5010

Practitioners & affiliated clinicians

Practitioners 673

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.

View all 673

NPI Registry JSON

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1720614217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281527",
            "telephone_number": "330-493-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USACS OF COLORADO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "BAGNOLI",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_title_or_position": "BOARD DIRECTOR",
        "authorized_official_telephone_number": "330-493-4443"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 17, 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.