Individual provider Active NPI

Anju K Sidhu, M.D.

  • Gastroenterology Physician
  • Colorado Springs, CO
National Provider Identifier
1114058344
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
DR.0052841 Issued in CO
Practice address
2920 N Cascade Ave
Third Floor
Colorado Springs, CO 80907-6262
Phone
(719) 636-1201
Fax
(719) 636-1326
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42757 CO
Gastroenterology Physician 207RG0100X DR.0052841 CO Primary

Addresses

Primary practice location

2920 N Cascade Ave
Third Floor
Colorado Springs, CO 80907-6262

Mailing address

2920 N Cascade Ave
Third Floor
Colorado Springs, CO 80907-6262
Phone (719) 636-1201

Other identifiers 1

IdentifierTypeStateIssuer
71279024MedicaidCO

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
I20140129000360 CO Practitioner - GastroenterologyPractitioner - Internal Medicine 5597811125 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42757COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System Current Accepting new patients
Salida Hospital District CurrentSince Apr 1, 2016 Accepting new patients
Portercare Adventist Health System CurrentSince Apr 1, 2015 Accepting new patients
Salida Hospital District Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Trinidad Area Health Association Internal Medicine Current Accepting new patients
Salida Hospital District Current Accepting new patients
Portercare Adventist Health System CurrentSince Apr 1, 2015 Accepting new patients
Trinidad Area Health Association CurrentSince Nov 1, 2018 Accepting new patients
Trinidad Area Health Association CurrentSince Nov 1, 2018 Accepting new patients
Maya LLC PastSince Feb 1, 2016 Accepting new patients

Locations

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

550 W US Highway 50
Salida, CO 81201
Phone (719) 530-2014

1000 Rush Dr
Salida, CO 81201
Phone (719) 530-2265

410 Benedicta Ave
Trinidad, CO 81082
Phone (719) 846-8051

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1114058344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE",
            "address_2": "THIRD FLOOR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076262",
            "telephone_number": "719-636-1201",
            "fax_number": "719-636-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE",
            "address_2": "THIRD FLOOR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076262",
            "telephone_number": "719-636-1201",
            "fax_number": "719-636-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "ANJU",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "42757",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "DR.0052841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71279024",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.