Individual provider Active NPI

Julia Michelle Cavallaro, M.D.

  • Family Medicine Physician
  • Fort Carson, CO
National Provider Identifier
1245416759
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0055815 Issued in CO
Practice address
1650 Cochrane Cir
Fort Carson, CO 80913-4613
Phone
(719) 524-4052
NPI assigned
Jan 15, 2008
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD441511 PA
Student in an Organized Health Care Education/Training Program 390200000X 0101242875 VA
Family Medicine Physician 207Q00000X DR.0055815 CO Primary

Addresses

Primary practice location

1650 Cochrane Cir
Fort Carson, CO 80913-4613

Mailing address

1650 Cochrane Cir
Fort Carson, CO 80913-4613
Phone (719) 524-4052

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230316002822 CO Practitioner - Family PracticePractitioner - Physical Medicine and Rehabilitation 6608046057 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0055815COMDFamily Medicine Physician
MD441511PAMDFamily Medicine Physician
0101242875VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Jun 15, 2024 Accepting new patients

Locations

7700 E Arapahoe Rd
Ste 220
Centennial, CO 80112
Phone (515) 513-4913

7900 E Union Ave
Ste 1100
Denver, CO 80237
Phone (469) 466-7420

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1245416759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-524-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-524-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLARO",
        "first_name": "JULIA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-15",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD441511",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0101242875",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0055815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.