NPIMap

Organization Active NPI

Matthews-Vu Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Colorado Springs, CO
National Provider Identifier
1174102149
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MATTHEWS-VU MEDICAL GROUP, P.C.
Practice address
1550 Pulsar Dr Ste 100
Colorado Springs, CO 80916-4503
Phone
(719) 632-4455
NPI assigned
Apr 6, 2021
Organization subpart
Yes
Parent organization
MATTHEWS-VU MEDICAL GROUP, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Kate Bogue
Title
Credentialing
Phone
(719) 632-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1550 Pulsar Dr Ste 100
Colorado Springs, CO 80916-4503

Mailing address

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110603000138 CO Part B Supplier - Clinic/Group Practice 3072790864 Receives reassigned benefits from 111 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colorado Springs, CO

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Matthews-Vu Medical Group P13 organizations share this tax ID, including this one
Part of
Matthews-Vu Medical Group P

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1174102149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 PULSAR DR STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809164503",
            "telephone_number": "719-632-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEWS-VU MEDICAL GROUP, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MATTHEWS-VU MEDICAL GROUP, P.C.",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "BOGUE",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "719-632-4455"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.