NPIMap

Individual provider Active NPI

Sipa Prabha Patel, D.O.

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1245511344
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0055610 Issued in CO
Practice address
1263 Lake Plaza Dr
Colorado Springs, CO 80906-3564
Phone
(719) 776-3300
Fax
(719) 776-3329
NPI assigned
Sep 1, 2011
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB09379800 NJ
Family Medicine Physician 207Q00000X DR.0055610 CO Primary

Addresses

Primary practice location

1263 Lake Plaza Dr
Colorado Springs, CO 80906-3564

Mailing address

1263 Lake Plaza Dr
Colorado Springs, CO 80906-3564
Phone (719) 776-3300

Other practice location 1

3027 N Circle Dr
Colorado Springs, CO 80909-1179
Phone (719) 776-4646

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
I20160106000886 CO Practitioner - Family Practice 8325267537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

3027 N Circle Dr
Colorado Springs, CO 80909-1179
Phone (719) 776-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0055610COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Family Medicine CurrentSince Nov 1, 2015 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2015 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Rowansom Dept of Pediatrics Past Accepting new patients

Locations

1263 Lake Plaza Dr
Ste 230
Colorado Springs, CO 80906
Phone (719) 345-1047

3027 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 577-2555

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 5

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1245511344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 LAKE PLAZA DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063564",
            "telephone_number": "719-776-3300",
            "fax_number": "719-776-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 LAKE PLAZA DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063564",
            "telephone_number": "719-776-3300",
            "fax_number": "719-776-3329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3027 N Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809091179",
            "country_code": "US",
            "telephone_number": "719-776-4646",
            "fax_number": "719-776-4640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SIPA",
        "middle_name": "PRABHA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB09379800",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0055610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.