TEEN CARE CENTER
NPI 1033614334
Pediatrics - Adolescent Medicine in Montrose, CO

Q: What is Pediatric Associates Prof LLC's NPI number?

The NPI number for Pediatric Associates Prof LLC is 1033614334. It was assigned to this organization in the NPPES registry on March 28, 2018. The provider is doing business as Teen Care Center.

Q: What is Pediatric Associates Prof LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Active since March 28, 2018CLIA 06D0518999 · Waiver

910 S 4TH ST, MONTROSE, CO 81401(970) 249-2421(970) 249-1203 Get Directions Write a Review

NPPES record last updated: March 28, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Teen Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TEEN CARE CENTER (NPI 1033614334) is a healthcare organization registered as an adolescent medicine in Montrose, Colorado and active in the NPI registry since March 2018. The organization holds a CLIA Waiver certificate valid through January 10, 2027 and lists Amber Hickert, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1033614334

Entity TypeOrganization

Primary Taxonomy2080A0000X

Legal Business NamePEDIATRIC ASSOCIATES PROF LLC

Location Address910 S 4TH STMontrose, CO 81401-4226

Mailing Address947 S 5th StMontrose, CO 81401-5716 · (970) 249-2421 · Fax (970) 249-1203

Phone(970) 249-2421

Fax(970) 249-1203

Organization SubpartYes

Authorized OfficialAmber HickertPractice Administrator · (970) 249-2421

Enumeration DateMarch 28, 2018

✔ NPI 1033614334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

910 S 4TH ST, Montrose, CO 81401

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Other Names 1

Doing Business AsTeen Care Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 06D0518999

Pediatric Associates Prof LLC · Montrose, CO

Active · expires Jan 10, 2027

CLIA Number06D0518999

Laboratory TypeRural Health Clinic

Certificate Effective DateJanuary 11, 2025

Certificate Expiration DateJanuary 10, 2027

Laboratory DirectorDr. Romeo Icasiano

Laboratory Phone(970) 249-2421

Laboratory LocationPediatric Associates Prof LLC947 South 5th St, Montrose, CO 81401

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RHONDA LYNN PARKER DO

Orthopaedic Surgery