NPIMap

Individual provider Active NPI

Jenny Lee, MD

  • Cardiovascular Disease Physician
  • Pueblo, CO
National Provider Identifier
1225184906
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
43172 Issued in CO
Practice address
3670 Parker Blvd
Suite 101
Pueblo, CO 81008-2285
Phone
(719) 564-1544
Fax
(719) 924-1593
NPI assigned
Jan 26, 2007
Last updated
Jul 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 43172 CO Primary

Addresses

Primary practice location

3670 Parker Blvd
Suite 101
Pueblo, CO 81008-2285

Mailing address

3670 Parker Blvd
Suite 101
Pueblo, CO 81008-2285
Phone (719) 564-1544

Other identifiers 2

IdentifierTypeStateIssuer
41672381MedicaidCO
P00986961OtherCORAILROAD MEDICARE

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
I20110216001049 CO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1557542099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2003
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)

109 Latigo LN
Suite E
Canon City, CO 81212-8113
Phone (719) 562-2900

1400 E Boulder
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

3670 Parker Blvd
Suite 101
Pueblo, CO 81008-2285
Phone (719) 562-2900

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

4050 Briargate Pkwy
Colorado Springs, CO 80920-7815

4080 Briargate Pkwy
Colorado Springs, CO 80920-7815
Phone (719) 365-6800

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43172COMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

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

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

3670 Parker Blvd
Pueblo, CO 81008
Phone (719) 564-1544

3670 Parker Blvd
Ste 101
Pueblo, CO 81008
Phone (719) 562-2900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1225184906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 PARKER BLVD",
            "address_2": "SUITE 101",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082285",
            "telephone_number": "719-564-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 PARKER BLVD",
            "address_2": "SUITE 101",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082285",
            "telephone_number": "719-564-1544",
            "fax_number": "719-924-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "43172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41672381",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00986961",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.