Organization Active NPI

Aurora Denver Medical Clinic, PC

  • Internal Medicine Physician
  • Aurora, CO
National Provider Identifier
1962410076
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36283 Issued in CO
Legal business name
AURORA DENVER MEDICAL CLINIC, PC
Practice address
3035 S Parker Rd
#554
Aurora, CO 80014-2926
Phone
(303) 338-9111
Fax
(303) 338-9122
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Cherry M Delosreyes, MDNPI 1629013057
Title
President
Phone
(303) 338-9111

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 36283 CO Primary

Addresses

Primary practice location

3035 S Parker Rd
#554
Aurora, CO 80014-2926

Mailing address

3035 S Parker Rd
#554
Aurora, CO 80014-2926
Phone (303) 338-9111

Other identifiers 1

IdentifierTypeStateIssuer
01362839MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000873 CO Part B Supplier - Clinic/Group Practice 6709871262 Receives reassigned benefits from 1 practitioner
Practice locations: Aurora, CO

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
06D1020745Aurora Denver Medical Clinic, PC3035 South Parker Rd, Aurora, CO 80014Certificate of waiverDec 30, 2027

National Provider Directory

National Provider Directory

Locations

3464 S Willow St
Ste 335
Denver, CO 80231

Practitioners & affiliated clinicians

Practitioners 1

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": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962410076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 S PARKER RD",
            "address_2": "#554",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142926",
            "telephone_number": "303-338-9111",
            "fax_number": "303-338-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 S PARKER RD",
            "address_2": "#554",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142926",
            "telephone_number": "303-338-9111",
            "fax_number": "303-338-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA DENVER MEDICAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DELOSREYES",
        "authorized_official_first_name": "CHERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-338-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "36283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01362839",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.