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Evergreen Pediatrics, LLC

Pediatrics Physician in Evergreen, CO · enumerated 2008 · authorized official Kenneth Kutalek, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1689839144

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Registry record

Entity type Organization (Type 2)
Legal business name Evergreen Pediatrics, LLC
Other name <Unavail>
Practice address 30960 Stagecoach Blvd, Suite W-120, Evergreen, CO, 80439
Phone (303) 674-6671
Fax (303) 674-0031
Enumeration date Jul 24, 2008
Last updated in NPPES Jul 24, 2008

Taxonomy & classification

208000000X Pediatrics Physician Allopathic & Osteopathic Physicians · License 26133 (CO) Primary

Authorized official

Name Kenneth Kutalek
Title Owner
Phone (303) 674-6671

Other identifiers

Identifier Type State Issuer
01261338 Medicaid CO -
04007977 Medicaid CO -
40308332 Medicaid CO -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Evergreen Pediatrics, LLC?
The NPI for Evergreen Pediatrics, LLC is 1689839144, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Evergreen Pediatrics, LLC?
NPPES lists Kenneth Kutalek (Owner) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-07-24.