MEDICARE: THE NEW HOPE CENTER FOR REPRODUCTIVE MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1083436034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEW HOPE CENTER FOR REPRODUCTIVE MEDICINE

Provider Business Mailing Address
First Line	:	9380 STATION ST STE 425
Second Line	:
City	:	LONE TREE
State	:	CO
Zip	:	80124-6832
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	448 VIKING DR STE 100
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7331
Country	:	US
Telephone Number	:	757-496-5370
Fax Number	:

Authorized Official
Title or Position	:	CHIEF MANAGED CARE OFFICER
Name	:	DIANE JEAN RAVECH
Credential	:
Telephone Number	:	860-305-6640

Provider Enumeration Date	:	10/30/2024
Last Update Date	:	04/24/2025

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