MEDICARE: NATHAN RUBALCAVA M.D.

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	DR.0075928	CO
2	208600000X	Surgery Physician	DR.0075928	CO
3	2086S0120X	Pediatric Surgery Physician	DR.0075928	CO

General Provider Information

NPI Number	:	1801282272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN RUBALCAVA M.D.

Provider Business Mailing Address
First Line	:	2055 N HIGH ST STE 370
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-5545
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 N HIGH ST STE 370
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-5545
Country	:	US
Telephone Number	:	303-839-6001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2015
Last Update Date	:	08/06/2025

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