COLORADO MEDICAL GROUP, PLLC – NPI #1811504582
Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

COLORADO MEDICAL GROUP, PLLC is a surgeon located in THORNTON, CO. NPPES has assigned the NPI number 1811504582 to COLORADO MEDICAL GROUP, PLLC on September 28, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0129X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Vascular Surgery

The NPI profile was last updated on Jul 21, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COLORADO MEDICAL GROUP, PLLC below.

NPI Profile for
COLORADO MEDICAL GROUP, PLLC

NPI Number
1811504582
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COLORADO MEDICAL GROUP, PLLC
Primary location
9195 GRANT ST STE 300
THORNTON, CO 80229-4386
Phone: (800) 991-6117 Fax: (888) 812-8191
Mailing address
3810 NORTHDALE BLVD STE 150
TAMPA, FL 33624-1871
Phone: (813) 961-1331 Fax: (888) 850-8316
Organization Subpart
No
Authorized Official
ALI WAZNI
CHIEF ADMINISTRATION OFFICER
Phone: (800) 991-6117
Updated
Certification Date
Jul 21, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0129X
- Surgery / Vascular Surgery (Primary)
208600000X
- Surgery

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.