SOUTH DENVER PHYSICIANS PLLC
NPI 1124463161
Internal Medicine in Centennial, CO
About South Denver Physicians Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH DENVER PHYSICIANS PLLC (NPI 1124463161) is a healthcare organization registered as an internal medicine in Centennial, Colorado and active in the NPI registry since May 2013. The organization holds a CLIA Waiver certificate valid through December 1, 2027 and lists Dmitriy I Pales, Sole Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Denver Physicians Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to South Denver Physicians PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: 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
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 06D2069723
South Denver Physicians, PLLC · Centennial, 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 South Denver Physicians PLLC's NPI number?
The NPI number for South Denver Physicians PLLC is 1124463161. It was assigned to this organization in the NPPES registry on May 3, 2013.
Where is South Denver Physicians PLLC located?
South Denver Physicians PLLC is located at 13111 E Briarwood Ave #370, Centennial, CO 80112. The listed phone number is (720) 441-4410.
What is South Denver Physicians PLLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is South Denver Physicians PLLC enrolled in Medicare?
Yes. South Denver Physicians PLLC is registered in the Medicare PECOS enrollment system.
When is South Denver Physicians PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Colorado, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through South Denver Physicians PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to South Denver Physicians PLLC, in Internal Medicine and Neurology. 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. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does South Denver Physicians PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 06D2069723) is associated with this NPI, valid through December 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for South Denver Physicians PLLC was last updated on March 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.
# South Denver Physicians Pllc · NPI 1124463161
Internal Medicine organization in Centennial, Colorado. Organization record, active in the CMS NPPES registry since May 3, 2013.
## Identity
- **NPI:** 1124463161 (Entity type: Organization)
- **Enumerated:** May 3, 2013
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Dmitriy Pales, SOLE MEMBER
## Practice location
- **Address:** 13111 E BRIARWOOD AVE, #370, Centennial, CO 80112
- **Phone:** (720) 441-4410 · **Fax:** (888) 474-7158
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Colorado, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (1), Neurology (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 13, 2014
- **Other identifiers:** Medicaid 148761 (CO)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124463161) · Data from the CMS NPPES public registry.