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COLORADO RETINA ASSOCIATES PLLC NPI 1942834841


NPI Information

NPI: 1942834841
Provider Name: COLORADO RETINA ASSOCIATES, PLLC

Former Legal Business Name: COLORADO RETINA ASSOCIATES, PC

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
1050 W SOUTH BOULDER RD STE 2100
LAFAYETTE, CO
ZIP 80026
Phone: (303) 261-1600
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COLORADO RETINA ASSOCIATES, PLLC is a medical specialty clinic center in Lafayette, CO. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). COLORADO RETINA ASSOCIATES, PLLC NPI is 1942834841. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Colorado Retina Associates, Pc.

The provider's business location address is:

1050 W SOUTH BOULDER RD STE 2100
LAFAYETTE, CO
ZIP 80026-818
Phone: (303) 261-1600
Fax: (303) 261-1601

The provider's authorized official is Kylie Wakasugi .
The authorized official title is Credentialing Specialist and has the following contact phone number (303) 261-1600.

The enumeration date for this NPI number is 2/28/2020 and was last updated on 11/17/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207WX0107XOphthalmologyRetina SpecialistNo
2207WX0108XOphthalmologyUveitis and Ocular Inflammatory DiseaseNo
3261QM2500XClinic/CenterMedical SpecialtyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
19000176494MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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