Individual provider Active NPI

Michael David Perry

  • Cardiovascular Disease Physician
  • Colorado Springs, CO
National Provider Identifier
1023337698
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
DR.0057253 Issued in CO
Practice address
1400 E Boulder St Ste 700
Colorado Springs, CO 80909-5533
Phone
(719) 635-7172
Fax
(719) 444-3759
NPI assigned
May 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB09323200 NJ
Internal Medicine Physician 207R00000X DR.0057253 CO
Cardiovascular Disease Physician 207RC0000X DR.0057253 CO Primary

Addresses

Primary practice location

1400 E Boulder St Ste 700
Colorado Springs, CO 80909-5533

Mailing address

1400 E Boulder St Ste 700
Colorado Springs, CO 80909-5533
Phone (719) 635-7172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160818001723 CO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5294966347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Lake Erie College of Osteopathic Medicine, Erie, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1100 Carson Ave
La Junta, CO 81050-2751
Phone (719) 384-5412

1400 E Boulder
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

16222 W US Hwy 24
Suite 200 Uchealth Family Medicine Woodla
Woodland Park, CO 80863-8763
Phone (719) 686-0878

16222 W US Hwy 24 220
Uchmg Woodland Park Outreach
Woodland Park, CO 80863-8763
Phone (719) 630-1006

16420 W US Hwy 24
Hospital Medicine Pikes Peak
Woodland Park, CO 80863-8760
Phone (719) 365-1292

3843 Rio Vista Dr
Colorado Springs, CO 80917-3335
Phone (719) 365-1950

4050 Briargate Pkwy
Colorado Springs, CO 80920-7815

4080 Briargate Pkwy
Colorado Springs, CO 80920-7815
Phone (719) 365-6800

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

5623 Pulpit Peak VW
Colorado Springs, CO 80918-3954
Phone (719) 365-1292

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Uchealth Grandview Hospital Hospital, Colorado Springs, CO, CCN 060130
  • Arkansas Valley Regional Medical Center Hospital, Lajuna, CO, CCN 061336
  • Uchealth Pikes Peak Regional Hospital Hospital, Woodland Park, CO, CCN 061326
  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DR.0057253COMDInternal Medicine Physician
25MB09323200NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 29, 2016 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

4110 Briargate Pkwy
Ste 400
Colorado Springs, CO 80920
Phone (719) 364-6550

1400 E Boulder St
Ste 700
Colorado Springs, CO 80909
Phone (719) 365-7172

1100 Carson Ave
La Junta, CO 81050
Phone (719) 383-6000

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1023337698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 700",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-635-7172",
            "fax_number": "719-444-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 700",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-635-7172",
            "fax_number": "719-444-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-21",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB09323200",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0057253",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "DR.0057253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.