Amy Susan Maroldo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28328 Issued in CO

Practice address

175 S. Union Blvd.
Suite 305
Colorado Springs, CO 80910-3126

Phone

(719) 365-6881

Fax

(719) 365-6877

NPI assigned

Feb 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Amy Susan Ekstrom Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1538958400
  NPD
• Memorial Health System

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1568668754

  Family Medicine

  NPD (past)
• Uch-MHS

  • Ambulance
  • Colorado Springs, CO
  • NPI 1417512559
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1174663140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 CENTENNIAL BLVD",
            "address_2": "#244",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073739",
            "telephone_number": "719-963-4170",
            "fax_number": "719-548-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S. UNION BLVD.",
            "address_2": "SUITE 305",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103126",
            "telephone_number": "719-365-6881",
            "fax_number": "719-365-6877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROLDO",
        "first_name": "AMY",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "28328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "MA28328",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01283282",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "EKSTROM",
            "middle_name": "SUSAN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stacie Marlow-Badgett
• Aylin Marmolejo
• Jose Alfredo Marmolejo
• Patricia Ann Maroda, PHYSICAL THERAPIST
• Marold Mindset Inc.
• Cathy Marquardt, OTR
• Kandi J Marquardt, LMT, CNMT
• Adriano Jamie Marquez
• Brittany Marquez
• Christopher Marquez, LPC

• Family Medicine Physician in Colorado Springs, CO
• Providers in Colorado Springs, 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 Aug 20, 2018; 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.