Individual provider Active NPI

Elizabeth E Stewart, M.D.

  • Internal Medicine Physician
  • Trinidad, CO
National Provider Identifier
1114998226
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0056640 Issued in CO
Practice address
400 Benedicta Ave
Suite a
Trinidad, CO 81082-2099
Phone
(719) 846-2206
NPI assigned
Jan 27, 2006
Last updated
May 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0056640 CO Primary

Addresses

Primary practice location

400 Benedicta Ave
Suite a
Trinidad, CO 81082-2099

Mailing address

400 Benedicta Ave
Trinidad, CO 81082-2099
Phone (719) 846-2206

Other identifiers 1

IdentifierTypeStateIssuer
55684211MedicaidCO

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
I20160428001056 CO Practitioner - Internal Medicine 9638357668 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinidad Area Health Association Internal Medicine CurrentSince Mar 21, 2016 Accepting new patients
Trinidad Area Health Association CurrentSince Mar 21, 2016 Accepting new patients

Locations

400 Benedicta Ave
Ste A
Trinidad, CO 81082
Phone (719) 846-2206

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

409 Benedicta Ave
Ste A
Trinidad, CO 81082
Phone (719) 846-8478

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1114998226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BENEDICTA AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822099",
            "telephone_number": "719-846-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BENEDICTA AVE",
            "address_2": "SUITE A",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822099",
            "telephone_number": "719-846-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "ELIZABETH",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0056640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55684211",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinidad, CO

Sources for this page

Verify at the official NPI Registry.