NPIMap

Individual provider Active NPI

Jennifer Fitzpatrick, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Pueblo, CO
National Provider Identifier
1154460186
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
49140 Issued in CO
Practice address
3676 Parker Blvd
Suite 390
Pueblo, CO 81008-2210
Phone
(719) 595-7780
Fax
(719) 595-7789
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 49140 CO Primary

Addresses

Primary practice location

3676 Parker Blvd
Suite 390
Pueblo, CO 81008-2210

Mailing address

3676 Parker Blvd
Suite 390
Pueblo, CO 81008-2210
Phone (719) 595-7780

Other identifiers 1

IdentifierTypeStateIssuer
06488846MedicaidCO

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
I20101019000951 CO Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 2365635653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of New Mexico School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

3676 Parker Blvd
Suite 390
Pueblo, CO 81008-2215
Phone (719) 595-7780

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

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

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Colorado Springs, CO, CCN 067449
  • Sangre de Cristo Community Care LLC Home health agency, La Junta, CO, CCN 067280
  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020
  • Prowers Medical Center Hospital, Lamar, CO, CCN 061323

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement34
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49140COMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Oct 6, 2025 Accepting new patients

Locations

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

3676 Parker Blvd
Ste 390
Pueblo, CO 81008
Phone (719) 595-7780

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1154460186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "address_2": "SUITE 390",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082210",
            "telephone_number": "719-595-7780",
            "fax_number": "719-595-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "address_2": "SUITE 390",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082210",
            "telephone_number": "719-595-7780",
            "fax_number": "719-595-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CO",
            "license": "49140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06488846",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.