Poudre Valley Medical Group, LLC
NPI 1205445772ActiveOrganization· Surgery, Plastic and Reconstructive Surgery· Denver, CO
Surgery, Plastic and Reconstructive Surgery in Denver, Colorado, registered in NPPES in July 2020, part of Poudre Valley Medical Group, LLC. The authorized official on file is Jana Conroy, Director Of Credentialing.
Overview
| NPI | 1205445772 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Poudre Valley Medical Group, LLC |
| NPI issued | Jul 30, 2020 |
| Last updated in NPPES | Jun 19, 2024 |
| Certified by provider | Jun 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Plastic and Reconstructive Surgery Primary | 2086S0122X | — | — |
| Dermatology | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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