| South Denver Gastroenterology, Pc | |
|
10103 Ridgegate Pkwy Ste 312 Lone Tree CO 80124-5520 | |
| (303) 788-8888 | |
| (866) 456-4594 |
| Full Name | South Denver Gastroenterology, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10103 Ridgegate Pkwy, Lone Tree, Colorado |
| Authorized Official Name and Position | Richard Roman (PRESIDENT) |
| Authorized Official Contact | 3037888888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Denver Gastroenterology, Pc 10103 Ridgegate Pkwy Ste 312 Lone Tree CO 80124-5520 Ph: (303) 788-8888 | South Denver Gastroenterology, Pc 10103 Ridgegate Pkwy Ste 312 Lone Tree CO 80124-5520 Ph: (303) 788-8888 |
| NPI Number | 1447364831 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 08/09/2023 |
| Medicare PECOS PAC ID | 2062302508 |
|---|---|
| Medicare Enrollment ID | O20040317001558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447364831 | NPI | - | NPPES |
| 04350088 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Marcelo Kugelmas |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992819130 PECOS PAC ID: 4880682806 Enrollment ID: I20040506000094 |
| Provider Name | Cary H Patt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801900048 PECOS PAC ID: 2567450786 Enrollment ID: I20040927000498 |
| Provider Name | Lawrence S Kim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275647414 PECOS PAC ID: 2961392402 Enrollment ID: I20041228000695 |
| Provider Name | Geoffrey Scott Jensen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518013143 PECOS PAC ID: 4688626245 Enrollment ID: I20050211000600 |
| Provider Name | Erik J Pieramici |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710091954 PECOS PAC ID: 5698718773 Enrollment ID: I20050609000349 |
| Provider Name | Frederick Wade Lewis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184738320 PECOS PAC ID: 9133019672 Enrollment ID: I20051004000005 |
| Provider Name | Richard Michael Roman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972616399 PECOS PAC ID: 2163457607 Enrollment ID: I20051004000016 |
| Provider Name | Fernando S Carreira |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396812251 PECOS PAC ID: 4486751617 Enrollment ID: I20070522000528 |
| Provider Name | Matthew T Nichols |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952451379 PECOS PAC ID: 4880795889 Enrollment ID: I20070720000349 |
| Provider Name | Mary A Kovalak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003861030 PECOS PAC ID: 9335165398 Enrollment ID: I20091007000760 |
| Provider Name | David M Scheider |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538273776 PECOS PAC ID: 6406746940 Enrollment ID: I20100729000779 |
| Provider Name | Aimee E Truesdale |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811034176 PECOS PAC ID: 9638202435 Enrollment ID: I20100730000356 |
| Provider Name | Lisa Rebecca Swize |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376680637 PECOS PAC ID: 3779777404 Enrollment ID: I20101027000332 |
| Provider Name | Christina J Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336351907 PECOS PAC ID: 1153599758 Enrollment ID: I20110726000862 |
| Provider Name | Kimberly Kristine James |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467723791 PECOS PAC ID: 8022271923 Enrollment ID: I20120511000249 |
| Provider Name | Erika M Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689848350 PECOS PAC ID: 2860673423 Enrollment ID: I20121004000308 |
| Provider Name | Sandra Rene Joll |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780787655 PECOS PAC ID: 8123152055 Enrollment ID: I20121101000473 |
| Provider Name | Catherine Obegi Jones |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1326323924 PECOS PAC ID: 1759520166 Enrollment ID: I20130615000016 |
| Provider Name | Stephen Russell Nash |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1053414045 PECOS PAC ID: 5597990655 Enrollment ID: I20131025000258 |
| Provider Name | Babac Vahabzadeh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265655153 PECOS PAC ID: 8426227208 Enrollment ID: I20140204000305 |
| Provider Name | Kyrsten Del Fairbanks |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457317638 PECOS PAC ID: 3870570138 Enrollment ID: I20140320002147 |
| Provider Name | Lisa A Nydam |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316096985 PECOS PAC ID: 7618914797 Enrollment ID: I20140327000732 |
| Provider Name | Peter N Le |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942460209 PECOS PAC ID: 4385862572 Enrollment ID: I20140829001996 |
| Provider Name | Lisa K Mathew |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639331200 PECOS PAC ID: 3173744034 Enrollment ID: I20141020000771 |
| Provider Name | Michael Gilger |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1467782003 PECOS PAC ID: 1254553654 Enrollment ID: I20141120000592 |
| Provider Name | Priscilla M Price |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679708804 PECOS PAC ID: 2567512098 Enrollment ID: I20150615001921 |
| Provider Name | Mandy Glasmeyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245612571 PECOS PAC ID: 8729396262 Enrollment ID: I20151001002387 |
| Provider Name | Kari L Buzard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346608064 PECOS PAC ID: 8123327939 Enrollment ID: I20161115000521 |
| Provider Name | Laura Rosenberg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912197005 PECOS PAC ID: 7315116092 Enrollment ID: I20161216000070 |
| Provider Name | Nathan Scott Heringhaus |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932452182 PECOS PAC ID: 5597917526 Enrollment ID: I20170119001868 |
| Provider Name | Alexander Ende |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437477197 PECOS PAC ID: 2163740937 Enrollment ID: I20170622002229 |
| Provider Name | Theresa Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457676645 PECOS PAC ID: 2264668433 Enrollment ID: I20170804003258 |
| Provider Name | Landon R Kleeb |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619248747 PECOS PAC ID: 7214196195 Enrollment ID: I20190108002563 |
| Provider Name | Peter Byrne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144693532 PECOS PAC ID: 2860785532 Enrollment ID: I20190404001361 |
| Provider Name | Lauren Luchini |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710345145 PECOS PAC ID: 0345545182 Enrollment ID: I20190618001626 |
| Provider Name | Nathan M Schomaker |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225472327 PECOS PAC ID: 7214179654 Enrollment ID: I20190715000443 |
| Provider Name | Ankush Kalra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811332364 PECOS PAC ID: 1850665704 Enrollment ID: I20200730001590 |
| Provider Name | Kayla Marie Mcclanahan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861015141 PECOS PAC ID: 1355766767 Enrollment ID: I20200803000471 |
| Provider Name | Ashley I Vachon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184042582 PECOS PAC ID: 4486872553 Enrollment ID: I20201014003907 |
| Provider Name | Drulana A. Sutton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851794929 PECOS PAC ID: 7517241458 Enrollment ID: I20201113000326 |
| Provider Name | Anna E Haberer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942842372 PECOS PAC ID: 7416384813 Enrollment ID: I20210315000651 |
| Provider Name | Erin M. Murphy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972544534 PECOS PAC ID: 2668361544 Enrollment ID: I20210630004249 |
| Provider Name | Christopher Morgan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1629264197 PECOS PAC ID: 2163578303 Enrollment ID: I20210712001977 |
| Provider Name | Mandip Kc |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487099685 PECOS PAC ID: 8628373628 Enrollment ID: I20220813000732 |
| Provider Name | Carl V Barlow |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750633780 PECOS PAC ID: 2062664840 Enrollment ID: I20220901001196 |
| Provider Name | Anya Blinov |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760037766 PECOS PAC ID: 4587991344 Enrollment ID: I20221214000017 |
| Provider Name | Christopher M Haydek |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164963336 PECOS PAC ID: 7214207091 Enrollment ID: I20230516000397 |
| Provider Name | Marlana J Radcliffe |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255794715 PECOS PAC ID: 0648516732 Enrollment ID: I20230518000795 |
| Provider Name | Dawn Denise Fangrow |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750675476 PECOS PAC ID: 5597934125 Enrollment ID: I20231115002733 |
| Provider Name | Danielle M Clark |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821352485 PECOS PAC ID: 4284881970 Enrollment ID: I20240229001620 |
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