Matthew David Pouliot, D.O.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

DR.0048088 Issued in CO

Practice address

3744 S Timberline Rd
Suite 102
Fort Collins, CO 80525-4333

Phone

(970) 495-0506

Fax

(970) 495-0485

NPI assigned

Jul 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CO, WY, NE3 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 3

Specialty

Physical Medicine and RehabilitationAlso: Osteopathic Manipulative Medicine, Pain Management

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, shared by 2 NPIs, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
• Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
• Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868

  Pain Medicine

  Medicare reassignment NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260

  Physical Medicine & Rehabilitation, WY

  Medicare reassignment NPD
• Box Butte General Hospital

  • Critical Access Hospital
  • Alliance, NE
  • NPI 1811929060
  Medicare reassignment NPD
• Box Butte General Hospital

  • Clinic/Center
  • Alliance, NE
  • NPI 1871652453
  Medicare reassignment NPD
• Box Butte General Hospital

  • Critical Access Hospital Clinic/Center
  • Alliance, NE
  • NPI 1346309929
  NPD
• Box Butte General Hospital

  • Rural Health Clinic/Center
  • Hemingford, NE
  • NPI 1609944388
  NPD
• Pain Partners MD LLC

  • Interventional Pain Medicine Physician
  • Lafayette, CO
  • NPI 1720160229
  NPD (past)

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

• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1104262286
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Loveland, CO
  • NPI 1750392304
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1780243055
  Care Compare affiliation
• Poudre Valley Health Care Inc

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1457494304

  Hospital

  Care Compare affiliation
• Poudre Valley Health Care Inc

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1679419808
  Care Compare affiliation
• Poudre Valley Health Care Inc

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1962158857
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1073172094
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1093374001
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1093374092
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1114586278
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1184283103
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Aurora, CO
  • NPI 1225610389
  Care Compare affiliation

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1154584266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3744 S TIMBERLINE RD",
            "address_2": "SUITE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254333",
            "telephone_number": "970-495-0506",
            "fax_number": "970-495-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3744 S TIMBERLINE RD",
            "address_2": "SUITE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254333",
            "telephone_number": "970-495-0506",
            "fax_number": "970-495-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIOT",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CO",
            "license": "DR.0048088",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CO",
            "license": "48088",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132413600",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026360700",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53107578",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Poudre Valley Medical Group, LLC
• Poudre Valley Open MRI, LLC
• Poudre Valley Periodontics & Dental Implants
• Poudre Valley Radiation Oncology LLC
• Elaine Marie Poulin, PHD
• Anne Karen Poulson, MA, MED, LPC, NCC
• Jennifer Jean Poulson, FNP
• Kayla Elizabeth Poulson, MA, LPC
• David B Powell, MD
• David L Powell, MAT-CERT. SPECIALIST

• Pain Medicine Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Pain Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.