NPIMap

Organization Active NPI

Madison Street Provider Network, LLC

  • Ophthalmology Physician
  • Englewood, CO
National Provider Identifier
1992650634
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MADISON STREET PROVIDER NETWORK, LLC
Practice address
10520 El Diente CT Ste a
Englewood, CO 80112-2656
Phone
(303) 377-2020
Fax
(303) 377-2022
NPI assigned
Feb 27, 2026
Last updated
Feb 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Authorized official

Name
Karen Gross
Title
Credentialing Manager
Phone
(303) 586-9390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

10520 El Diente CT Ste a
Englewood, CO 80112-2656

Mailing address

PO Box 912914
Denver, CO 80291-2914
Phone (303) 377-2020

National Provider Directory

National Provider Directory
Tax ID family
Madison St Provider Network10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

10520 El Diente Ct
Ste A
Englewood, CO 80112
Phone (720) 414-5310

NPI Registry JSON

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

{
    "created_epoch": "1772150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772150400000",
    "number": "1992650634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912914",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912914",
            "telephone_number": "303-377-2020",
            "fax_number": "303-377-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 EL DIENTE CT STE A",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801122656",
            "telephone_number": "303-377-2020",
            "fax_number": "303-377-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON STREET PROVIDER NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "303-586-9390"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.