NPIMap

Organization Active NPI

Peak Pediatrics PLLC

  • Clinic/Center
  • Wheat Ridge, CO
National Provider Identifier
1952471971
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PEAK PEDIATRICS PLLC
Practice address
3555 Lutheran Pkwy Ste 340
Wheat Ridge, CO 80033-6039
Phone
(303) 996-6005
Fax
(303) 420-8831
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Melissa Ann Herrmann, CMC
Title
Billing Manager
Phone
(303) 996-6005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X CO
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3555 Lutheran Pkwy Ste 340
Wheat Ridge, CO 80033-6039

Mailing address

3555 Lutheran Pkwy
#340
Wheat Ridge, CO 80033-6021
Phone (303) 996-6005

Other practice location 1

2900 E 136th Ave Ste 201
Thornton, CO 80241-3542
Phone (303) 996-6005

Other identifiers 2

IdentifierTypeStateIssuer
9000105583MedicaidCO
62657763MedicaidCO

Other names 1

  • PEAK PEDIATRICS Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0985275Peak Pediatrics -Wheat Ridge3555 Lutheran Pkwy, Ste 340, Wheat Ridge, CO 80033Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Peak Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2900 E 136th Ave
Ste 200
Thornton, CO 80241

3555 Lutheran Pkwy
Ste 340
Wheat Ridge, CO 80033
Phone (303) 996-6005

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1952471971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 LUTHERAN PKWY",
            "address_2": "#340",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336021",
            "telephone_number": "303-996-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 LUTHERAN PKWY STE 340",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336039",
            "telephone_number": "303-996-6005",
            "fax_number": "303-420-8831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 E 136th Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802413542",
            "country_code": "US",
            "telephone_number": "303-996-6005",
            "fax_number": "303-420-8831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEAK PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-07-21",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "HERRMANN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "303-996-6005",
        "authorized_official_credential": "CMC"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000105583",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62657763",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEAK PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.