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PEDIACLINIC LLC
NPI 1194587964
Pediatrics in Castle Rock, CO

Active since January 26, 2024CLIA Certified · 2 labs
3911 AMBROSIA ST STE 100, CASTLE ROCK, CO 80109(303) 302-3879(720) 325-2327 Get Directions Write a Review

NPPES record last updated: October 6, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediaclinic Llc NPPES

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

PEDIACLINIC LLC (NPI 1194587964) is a healthcare organization registered as a pediatrics in Castle Rock, Colorado and active in the NPI registry since January 2024. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Highlands Ranch, and lists Daniel James Feiten, Manager, as its authorized official.

NPPES Registry Identity

NPI1194587964
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDIACLINIC LLC
Location Address3911 AMBROSIA ST STE 100Castle Rock, CO 80109-3887
Mailing Address9555 S University Blvd Unit 102Highlands Ranch, CO 80126-8114 · (303) 302-3879
Phone(303) 302-3879
Fax(720) 325-2327
Organization SubpartYesParent: Pediaclinic
Authorized OfficialDaniel James FeitenManager · (303) 981-1494
Enumeration DateJanuary 26, 2024
Last NPPES UpdateOctober 6, 2025
NPPES CertifiedOctober 6, 2025
✔ NPI 1194587964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3911 AMBROSIA ST STE 100, Castle Rock, CO 80109
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Secondary Practice Location 1

Location 19555 S University Blvd Unit 102Highlands Ranch, CO 80126-8114 · Phone (303) 302-3879

Other Identifiers 2

Other1851866180Nppes
Medicaid179794CO

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 2

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 06D2191574

Pediaclinic LLC · Highlands Ranch, CO
Active · expires Aug 27, 2026
CLIA Number06D2191574
Laboratory TypeUrgent Care
Certificate Effective DateAugust 28, 2024
Certificate Expiration DateAugust 27, 2026
Laboratory DirectorDr. Nicholas Krebs
Laboratory Phone(303) 302-3879
Laboratory LocationPediaclinic LLC9555 S University Blvd, Highlands Ranch, CO 80126
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 06D2332497

Pediaclinic · Castle Rock, CO
Active · expires Oct 20, 2027
CLIA Number06D2332497
Laboratory TypeUrgent Care
Certificate Effective DateOctober 21, 2025
Certificate Expiration DateOctober 20, 2027
Laboratory DirectorDaniel J. Feiten
Laboratory Phone(303) 406-9454
Laboratory LocationPediaclinic360 Ambrosia St, Ste 100, Castle Rock, CO 80109
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

PEDIATRICS AT THE MEADOWS, P.C.
Pediatrics
3911 AMBROSIA ST STE 100
CASTLE ROCK, CO 80109
Douglas County (303) 688-5226
WAY CENTER INC
Clinic/Center (Adolescent and Children Mental Health)
3911 AMBROSIA ST STE 100
CASTLE ROCK, CO 80109
Douglas County (303) 688-5226

Frequently 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 Pediaclinic LLC's NPI number?

The NPI number for Pediaclinic LLC is 1194587964. It was assigned to this organization in the NPPES registry on January 26, 2024.

Where is Pediaclinic LLC located?

Pediaclinic LLC is located at 3911 Ambrosia St Ste 100, Castle Rock, CO 80109. The listed phone number is (303) 302-3879.

What is Pediaclinic LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Pediaclinic LLC hold CLIA laboratory certificates?

Yes. 2 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 Pediaclinic LLC was last updated on October 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.