SOUTH DENVER INTERNAL MEDICINE AND PEDIATRICS, P.C.
NPI 1376671628
Clinic/Center - Primary Care in Lone Tree, CO
About South Denver Internal Medicine And Pediatrics, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH DENVER INTERNAL MEDICINE AND PEDIATRICS, P.C. (NPI 1376671628) is a healthcare organization registered as a primary care in Lone Tree, Colorado and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through August 10, 2027 and lists Charles Miranda, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 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)
South Denver Internal Medicine And Pediatrics, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to South Denver Internal Medicine And Pediatrics, P.C., which bills Medicare for the services this clinician delivers.
Clinician (1)
Lone Tree, CO 80124
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 06D1015600
South Denver Internal Medicine · Lone Tree, 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 Internal Medicine And Pediatrics, P.C.'s NPI number?
The NPI number for South Denver Internal Medicine And Pediatrics, P.C. is 1376671628. It was assigned to this organization in the NPPES registry on March 1, 2007.
Where is South Denver Internal Medicine And Pediatrics, P.C. located?
South Denver Internal Medicine And Pediatrics, P.C. is located at 10103 Ridgegate Pkwy Suite 114, Lone Tree, CO 80124. The listed phone number is (303) 799-8890.
What is South Denver Internal Medicine And Pediatrics, P.C.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is South Denver Internal Medicine And Pediatrics, P.C. enrolled in Medicare?
Yes. South Denver Internal Medicine And Pediatrics, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Denver Internal Medicine And Pediatrics, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to South Denver Internal Medicine And Pediatrics, P.C.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does South Denver Internal Medicine And Pediatrics, P.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 06D1015600) is associated with this NPI, valid through August 10, 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 Internal Medicine And Pediatrics, P.C. was last updated on February 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 Internal Medicine And Pediatrics, P.c. · NPI 1376671628
Primary Care organization in Lone Tree, Colorado. Organization record, active in the CMS NPPES registry since March 1, 2007.
## Identity
- **NPI:** 1376671628 (Entity type: Organization)
- **Enumerated:** March 1, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Charles Miranda, PRESIDENT
## Practice location
- **Address:** 10103 RIDGEGATE PKWY, SUITE 114, Lone Tree, CO 80124-5520
- **Phone:** (303) 799-8890 · **Fax:** (303) 799-8891
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 8, 2010
- **Other identifiers:** Medicare PIN C506878
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1376671628) · Data from the CMS NPPES public registry.