Individual provider Active NPI

Maritza Proano, M.D.

  • Gastroenterology Physician
  • Pueblo, CO
National Provider Identifier
1194742676
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
10153 Issued in ND
Practice address
1600 N Grand Ave
Suite 440
Pueblo, CO 81003-2760
Phone
(719) 543-3500
Fax
(719) 543-3504
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD2025-0654 NM
Gastroenterology Physician 207RG0100X 10153 ND Primary

Addresses

Primary practice location

1600 N Grand Ave
Suite 440
Pueblo, CO 81003-2760

Mailing address

1600 N Grand Ave
Suite 440
Pueblo, CO 81003-2760
Phone (719) 543-3500

Other practice location 1

630 W Maple St
Farmington, NM 87401-6113
Phone (505) 609-6349

Other identifiers 1

IdentifierTypeStateIssuer
13702MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NM2 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

Enrollment IDStateProvider typePAC IDDetails
I20170228000817 CO Practitioner - Gastroenterology 1759395817 Reassigns benefits to 1 organization
I20250724001764 NM Practitioner - Gastroenterology 1759395817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Columbia University College of Physicians and Surgeons, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Diseases Specialists of Colorado,LLCGroup PAC ID 8527022060, 4 clinicians
San Juan Regional Medical Center, Inc.Group PAC ID 4587559505, 233 clinicians

Practice addresses (Care Compare)

1600 N Grand Ave
Suite 440
Pueblo, CO 81003-2760
Phone (719) 543-3500

630 W Maple St
SJHP Gastroenterology
Farmington, NM 87401-6113
Phone (505) 609-6349

Hospital & facility affiliations

  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy103
Upper gastrointestinal (GI) endoscopy for acid reflux91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc Gastroenterology CurrentSince Jul 7, 2025 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Jul 7, 2025 Accepting new patients
Digestive Diseases Specialists of Colorado,LLC Gastroenterology CurrentSince Sep 10, 2018 Accepting new patients

Locations

1600 N Grand Ave
Ste 440
Pueblo, CO 81003
Phone (719) 543-3500

801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011

630 W Maple St
Farmington, NM 87401
Phone (505) 325-1123

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Organizations & group practices 3

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 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1194742676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 440",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032760",
            "telephone_number": "719-543-3500",
            "fax_number": "719-543-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 440",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032760",
            "telephone_number": "719-543-3500",
            "fax_number": "719-543-3504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 W Maple St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874016113",
            "country_code": "US",
            "telephone_number": "505-609-6349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROANO",
        "first_name": "MARITZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "MD2025-0654",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ND",
            "license": "10153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13702",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.