Mta Medical Group LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MTA MEDICAL GROUP LLC

Practice address

2620 S Parker Rd Ste 273
Aurora, CO 80014-1627

Phone

(720) 269-4539

Fax

(720) 269-4539

NPI assigned

Jun 26, 2019

Organization subpart

No

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

Authorized official

Name

Ainur Sadygulova

Title

Co-Owner

Phone

(720) 269-4539

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1962063305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 S PARKER RD STE 273",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141627",
            "telephone_number": "720-269-4539",
            "fax_number": "720-269-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 S PARKER RD STE 273",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141627",
            "telephone_number": "720-269-4539",
            "fax_number": "720-269-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "SADYGULOVA",
        "authorized_official_first_name": "AINUR",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "720-269-4539"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX LICENCE",
            "identifier": "36157938",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mtamedicalgroup@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "2620 S Parker Rd Ste 273",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800141627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.