Kimberly Matz Gugliotto, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0064179 Issued in CO

Practice address

1338 Phay Ave
Canon City, CO 81212-2399

Phone

(719) 285-2000

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Usacs of Colorado, Inc

  • Emergency Medicine Physician
  • Littleton, CO
  • NPI 1760415871

  CO

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• East Morgan County Hospital

  • Critical Access Hospital
  • Brush, CO
  • NPI 1699708743

  CO

  Medicare reassignment
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Denver, CO
  • NPI 1104452952
  NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Lakewood, CO
  • NPI 1720614217
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD
• Sterling Regional Medcenter

  • General Acute Care Hospital
  • Sterling, CO
  • NPI 1942238555
  NPD (past)

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1144601196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 GREEN HAVEN CIR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801267540",
            "telephone_number": "253-906-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122399",
            "telephone_number": "719-285-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZ GUGLIOTTO",
        "first_name": "KIMBERLY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0064179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY MEDICINE",
            "identifier": "1144601196",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Kay Martin, MSW
• Leona Martinez
• Rose Therese Martinez
• Roxanne Ellen Martinez, PTA
• Tricia Mattson
• Bethany A Maxwell
• Rachel Ruth Maxwell, DPT
• Kapryce Mayfield Spradlin
• Lindsay Mays
• Nicholas Mazzoni

• Family Medicine Physician in Canon City, CO
• Providers in Canon City, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.