NPIMap

Organization Active NPI

Summit Medical Consultants Aco Prof LLC

Doing business as Summit Medical Consultants ACO

  • Internal Medicine Physician
  • Greenwood Village, CO
National Provider Identifier
1891471207
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SUMMIT MEDICAL CONSULTANTS ACO PROF LLC
Doing business as
Summit Medical Consultants ACO
Practice address
9250 E Costilla Ave Ste 540
Greenwood Village, CO 80112-3648
Phone
(720) 644-9355
NPI assigned
Jun 22, 2023
Last updated
Nov 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Authorized official

Name
Rajendra Kadari, MDNPI 1598946675
Title
Physician/Owner
Phone
(720) 644-9355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

9250 E Costilla Ave Ste 540
Greenwood Village, CO 80112-3648

Mailing address

9250 E Costilla Ave Ste 540
Greenwood Village, CO 80112-3648
Phone (720) 644-9355

Other names 1

  • Summit Medical Consultants ACO Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230824000305 CO Part B Supplier - Clinic/Group Practice 2961865993 Receives reassigned benefits from 98 practitioners
1 other NPI on this enrollment

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 103

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 103

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1891471207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 E COSTILLA AVE STE 540",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801123648",
            "telephone_number": "720-644-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 E COSTILLA AVE STE 540",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801123648",
            "telephone_number": "720-644-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL CONSULTANTS ACO PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "KADARI",
        "authorized_official_first_name": "RAJENDRA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "720-644-9355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Medical Consultants ACO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood Village, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.