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NPI Code Detail

MEDICARE: COLORADO SURGICAL AFFILIATES, LLC

MEDICARE: COLORADO SURGICAL AFFILIATES, LLC
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
1208800000XUrology Physician

General Provider Information

NPI Number : 1942138979
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLORADO SURGICAL AFFILIATES, LLC
Provider Business Mailing Address
First Line : 2440 N 11TH ST
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81501-8102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2737 CROSSROADS BLVD
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81506-3954
Country : US
Telephone Number : 970-243-3061
Fax Number :
Authorized Official
Title or Position : REVENUE CYCLE DIRECTOR
Name : JACQUELINE S NESTLE
Credential :
Telephone Number : 970-244-5945
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “COLORADO SURGICAL AFFILIATES, LLC ” Practice Location

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