MAGNOLIA MEDICAL GROUP
NPI 1003672619
Internal Medicine - Addiction Medicine in Denver, CO
About Magnolia Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAGNOLIA MEDICAL GROUP (NPI 1003672619) is a healthcare organization registered as an addiction medicine in Denver, Colorado and active in the NPI registry since February 2024. The organization holds 4 active CLIA laboratory certificates and lists Pradeep Rai, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Magnolia Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
30Medicare enrollment records show 30 clinicians reassign Medicare billing to Magnolia Medical Group, which bills Medicare for the services they deliver. Of these, 14 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 9
Nearest to this location (20)
See all 30Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 4
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 06D2158266
Magnolia Medical Group · Denver, COCertificate of Waiver 06D2347115
Magnolia Medical Group · Denver, COCertificate of Accreditation 06D2121590
Magnolia Medical Group · Denver, COCertificate of Waiver 06D2157528
Magnolia Medical Group · Denver, COFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Magnolia Medical Group's NPI number?
The NPI number for Magnolia Medical Group is 1003672619. It was assigned to this organization in the NPPES registry on February 22, 2024.
Where is Magnolia Medical Group located?
Magnolia Medical Group is located at 1490 N Lafayette St Ste 104, Denver, CO 80218. The listed phone number is (303) 209-5115.
What is Magnolia Medical Group's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.
Is Magnolia Medical Group enrolled in Medicare?
Yes. Magnolia Medical Group is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Magnolia Medical Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 30 clinicians in 9 Medicare specialties reassign their Medicare billing to Magnolia Medical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (19), General Practice (4) and Clinical Social Worker (1). Of these, 14 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Magnolia Medical Group hold CLIA laboratory certificates?
Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Magnolia Medical Group was last updated on February 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Magnolia Medical Group · NPI 1003672619
Addiction Medicine organization in Denver, Colorado. Organization record, active in the CMS NPPES registry since February 22, 2024.
## Identity
- **NPI:** 1003672619 (Entity type: Organization)
- **Enumerated:** February 22, 2024
- **Primary specialty:** Internal Medicine - Addiction Medicine · taxonomy 207RA0401X
- **Organization subpart:** No
- **Authorized official:** Pradeep Rai, DIRECTOR
## Practice location
- **Address:** 1490 N LAFAYETTE ST STE 104, Denver, CO 80218-2391
- **Phone:** (303) 209-5115
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 30 clinicians in 9 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (19), General Practice (4), Clinical Social Worker (1); 14 practice within 10 miles; [full list](https://npiprofile.com/npi/1003672619/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 17, 2026
- **CLIA laboratory certificates:** 4 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003672619) · Data from the CMS NPPES public registry.