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BANNER HOSPITAL BASED PHYSICIANS COLORADO LLC
NPI 1275871204
Clinic/Center - Multi-Specialty in Brush, CO

Active since January 25, 2013
2400 EDISON ST, BRUSH, CO 80723(970) 842-6200(970) 842-6290 Get Directions Write a Review

NPPES record last updated: April 20, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Banner Hospital Based Physicians Colorado Llc NPPES

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

BANNER HOSPITAL BASED PHYSICIANS COLORADO LLC (NPI 1275871204) is a healthcare organization registered as a multi-specialty in Brush, Colorado and active in the NPI registry since January 2013. The organization lists Shiva Birdi, Bmg Ceo, as its authorized official.

NPPES Registry Identity

NPI1275871204
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameBANNER HOSPITAL BASED PHYSICIANS COLORADO LLC
Location Address2400 EDISON STBrush, CO 80723-1640
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702
Phone(970) 842-6200
Fax(970) 842-6290
Organization SubpartYesParent: Banner Medical Group Colorado
Authorized OfficialShiva BirdiBmg Ceo · (480) 256-3336
Enumeration DateJanuary 25, 2013
Last NPPES UpdateApril 20, 2023
NPPES CertifiedApril 20, 2023
✔ NPI 1275871204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
2400 EDISON ST, Brush, CO 80723
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Banner Hospital Based Physicians Colorado Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

163

Medicare enrollment records show 163 clinicians reassign Medicare billing to Banner Hospital Based Physicians Colorado LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 29

Family Practice30
Internal Medicine26
Nurse Practitioner25
Obstetrics/Gynecology9
Radiation Oncology9
Hospitalist6
Critical Care (Intensivists)5
General Surgery5
21 other specialties48

Nearest to this location (20)

See all 163
Jay Cook, M.D.
Diagnostic Radiology
NPI 1871576520
2400 EDISON ST
Brush, CO 80723
(970) 842-6256
✔ PECOS✔ Accepts MedicareSame address
Robert Dillon, MD
Family Practice
NPI 1629119383
2400 EDISON ST
Brush, CO 80723
(702) 453-3799
✔ PECOS✔ Accepts MedicareSame address
Bonnie Brownell, NP
Nurse Practitioner
NPI 1942630835
615 FAIRHURST ST FAMILY CARE CLINIC
Sterling, CO 80751
(970) 521-3251
✔ PECOS✔ Accepts Medicare33 mi
Justin Walker, M.D.
Family Practice
NPI 1871799726
2930 11TH AVE
Evans, CO 80620
(970) 353-9403
✔ PECOS✔ Accepts Medicare56 mi
Kenneth Richards, MD
Cardiac Surgery
NPI 1083689376
1800 15TH ST SUITE 340
Greeley, CO 80631
(970) 378-4593
✔ PECOS57 mi
Randall Marsh, MD
Cardiovascular Disease (Cardiology)
NPI 1720042161
1800 15TH ST SUITE 310
Greeley, CO 80631
(970) 392-0900
✔ PECOS✔ Accepts Medicare57 mi
Caleb Barnhill, M.D.
Plastic and Reconstructive Surgery
NPI 1225417728
1801 16TH ST
Greeley, CO 80631
(970) 810-4121
✔ PECOS✔ Accepts Medicare57 mi
Tesfaye Demeke, MD
Internal Medicine
NPI 1255352217
1801 16TH ST HOSPITALIST OFFICE
Greeley, CO 80631
(970) 378-4529
✔ PECOS✔ Accepts Medicare57 mi
Mark Dziemianowicz, MD
Radiation Oncology
NPI 1154776029
1801 16TH ST
Greeley, CO 80631
(970) 810-3894
✔ PECOS✔ Accepts Medicare57 mi
Gretchen Evans, MD, MPH
Gastroenterology
NPI 1184144230
1801 16TH ST
Greeley, CO 80631
(970) 810-4475
✔ PECOS✔ Accepts Medicare57 mi
Lin Hao, MD
Hematology/Oncology
NPI 1528325529
1801 16TH ST
Greeley, CO 80631
(970) 810-3894
✔ PECOS✔ Accepts Medicare57 mi
Ashley Imburgia, PSY.D
Clinical Psychologist
NPI 1295201291
1801 16TH STREET
Greeley, CO 80631
(970) 810-3894
✔ PECOS✔ Accepts Medicare57 mi
Travis Mason, MD
Surgical Oncology
NPI 1578720926
1801 16TH ST
Greeley, CO 80631
(970) 810-3894
✔ PECOS✔ Accepts Medicare57 mi
Kelsey Shay, M.D.
General Surgery
NPI 1306001797
1801 16TH ST
Greeley, CO 80631
(970) 810-3894
✔ PECOS✔ Accepts Medicare57 mi
Jason Tcheng, MD, FACS
Thoracic Surgery
NPI 1215137237
1801 16TH ST
Greeley, CO 80631
(970) 810-3894
✔ PECOS✔ Accepts Medicare57 mi
Christopher Michael, MD
Anesthesiology
NPI 1689607491
16696 CR 70
Greeley, CO 80631
(970) 350-4800
✔ PECOS✔ Accepts Medicare60 mi
Curtis Crylen, M.D.
Urology
NPI 1881644532
5890 W 13TH STREET SUITE 106
Greeley, CO 80634
(970) 378-1000
✔ PECOS✔ Accepts Medicare60 mi
Daniel Heaston, M.D.
Orthopedic Surgery
NPI 1871715078
5890 W 13TH ST STE 101
Greeley, CO 80634
(970) 810-0020
✔ PECOS✔ Accepts Medicare60 mi
Robin Lacour, M.D.
Gynecological Oncology
NPI 1548448442
1801 16TH ST
Greeley, CO 80631
(970) 810-3894
✔ PECOS✔ Accepts Medicare64 mi
Ifeanyichukwu Nwobodo, M.D.
Hospitalist
NPI 1497922074
24974 E GLASGOW DR
Aurora, CO 80016
(510) 427-8548
✔ PECOS✔ Accepts Medicare72 mi
See all 163 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Banner Hospital Based Physicians Colorado LLC's NPI number?

The NPI number for Banner Hospital Based Physicians Colorado LLC is 1275871204. It was assigned to this organization in the NPPES registry on January 25, 2013.

Where is Banner Hospital Based Physicians Colorado LLC located?

Banner Hospital Based Physicians Colorado LLC is located at 2400 Edison St, Brush, CO 80723. The listed phone number is (970) 842-6200.

What is Banner Hospital Based Physicians Colorado LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Banner Hospital Based Physicians Colorado LLC enrolled in Medicare?

Yes. Banner Hospital Based Physicians Colorado LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Banner Hospital Based Physicians Colorado LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 163 clinicians in 29 Medicare specialties reassign their Medicare billing to Banner Hospital Based Physicians Colorado LLC. 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 Family Practice (30), Internal Medicine (26) and Nurse Practitioner (25). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Banner Hospital Based Physicians Colorado LLC was last updated on April 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.