1013800705 NPI number — SUMMIT RHEUMATOLOGY AND ARTHRITIS -COLORADO PLLC

Table of content: MIGUEL A HERNANDEZ MORENO RESIDENT IN TRAINING (NPI 1801372040)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013800705 NPI number — SUMMIT RHEUMATOLOGY AND ARTHRITIS -COLORADO PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUMMIT RHEUMATOLOGY AND ARTHRITIS -COLORADO PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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Provider Other Middle Name:
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NPI Number Information

NPI Number:
1013800705
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/31/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2451 E BASELINE RD STE 450
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GILBERT
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85234-2473
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
991 SOUTHPARK DR STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80120-5688
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-886-6704
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2025

Additional Information

Authorized Official

Authorized Official Last Name:
PANICO
Authorized Official First Name:
BRITTANY
Authorized Official Middle Name:
SUMMER
Authorized Official Title or Position:
OWNER/SIGNER
Authorized Official Telephone Number:
480-494-2770

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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