Individual provider Active NPI

Paige L. Neifert, M.D.

  • Dermatology Physician
  • Colorado Springs, CO
National Provider Identifier
1255322319
Registry record updated Mar 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
DR0054452 Issued in CO
Practice address
2405 Research Pkwy
Colorado Springs, CO 80920-1044
Phone
(719) 228-0400
Fax
(719) 268-2827
NPI assigned
Oct 28, 2005
Last updated
Mar 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A36171 CA
Dermatology Physician 207N00000X DR0054452 CO Primary

Addresses

Primary practice location

2405 Research Pkwy
Colorado Springs, CO 80920-1044

Mailing address

2 South Cascade Avenue
Suite 140
Colorado Springs, CO 80903-1604
Phone (719) 538-2900

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
I20170803001444 CO Practitioner - Dermatology 6709157118 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A36171CAMDDermatology Physician
DR0054452COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Colorado Medical Group LLC CurrentSince Aug 7, 2017 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Aug 7, 2017 Accepting new patients

Locations

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

1633 Medical Center Pt
Colorado Springs, CO 80907
Phone (719) 636-2999

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

2405 Research Pkwy
Colorado Springs, CO 80920
Phone (719) 268-2800

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.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583020800000",
    "number": "1255322319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SOUTH CASCADE AVENUE",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031604",
            "telephone_number": "719-538-2900",
            "fax_number": "719-538-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 RESEARCH PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201044",
            "telephone_number": "719-228-0400",
            "fax_number": "719-268-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIFERT",
        "first_name": "PAIGE",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2020-03-01",
        "certification_date": "2020-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A36171",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR0054452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.