NPIMap

Individual provider Active NPI

Anneliese Marie Hale, PA-C

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1063963809
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004819 Issued in CO
Practice address
4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075
Phone
(719) 632-4455
Fax
(719) 633-4613
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0004819 CO Primary

Addresses

Primary practice location

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075

Mailing address

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075
Phone (719) 632-4455

Other practice location 1

400 W 16th St
Pueblo, CO 81003-2745
Phone (719) 584-4306

Other names 1

  • Anneliese Marie Rotering Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161029000135 CO Practitioner - Physician Assistant 2860770658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matthews-Vu Medical Group, P.C.Group PAC ID 3072790864, 39 clinicians

Practice addresses (Care Compare)

104 Pro Rodeo Dr
Suite 100
Colorado Springs, CO 80919-2334
Phone (719) 555-0707

4190 E Woodmen Rd
Colorado Springs, CO 80920-8075
Phone (719) 632-4455

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Medical Group Colorado PLLC CurrentSince Oct 21, 2025 Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Jan 15, 2018 Accepting new patients
Matthews-Vu Medical Group, P.C. Current Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Jan 15, 2018 Accepting new patients

Locations

4190 E Woodmen Rd
Colorado Springs, CO 80920
Phone (719) 722-2542

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 364-4851

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

4190 E Woodmen Rd
Ste 230
Colorado Springs, CO 80920

999 17th St
Ste 500
Denver, CO 80202
Phone (720) 355-0539

Interoperability endpoints

  • Direct secure messaging: anneliese.hale@mvmg.eclinicaldirectplus.com

Organizations & group practices 4

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1063963809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075",
            "telephone_number": "719-632-4455",
            "fax_number": "719-633-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075",
            "telephone_number": "719-632-4455",
            "fax_number": "719-633-4613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W 16th St",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810032745",
            "country_code": "US",
            "telephone_number": "719-584-4306",
            "fax_number": "719-595-7886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALE",
        "first_name": "ANNELIESE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNELIESE",
            "last_name": "ROTERING",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.