NPIMap

Individual provider Active NPI

Elijah Seeger Grillo, M.D.

  • Internal Medicine Physician
  • Lone Tree, CO
National Provider Identifier
1285029447
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0059882 Issued in CO
Practice address
9695 S Yosemite St Ste 224
Lone Tree, CO 80124-2890
Phone
(303) 265-3970
Fax
(303) 265-3971
NPI assigned
Apr 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0059882 CO Primary

Addresses

Primary practice location

9695 S Yosemite St Ste 224
Lone Tree, CO 80124-2890

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4123

Other practice location 1

4102 Pinion Drive, 10th Medical Group
USAF Academy
Colorado Springs, CO 80840
Phone (719) 333-5090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210331001799 WY Practitioner - Internal Medicine 2961717996 Reassigns benefits to 1 organization
I20220824001825 CO Practitioner - Internal Medicine 2961717996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

9695 S Yosemite St
Suite 224 Uchmg Primary Care Yosemite
Lone Tree, CO 80124-2890
Phone (303) 265-3970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0059882COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Physicians Group-Pannu PLLC Internal Medicine CurrentSince Jan 28, 2021 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 12, 2022 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 12, 2022 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

5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111

9695 S Yosemite St
Ste 224UCHMG
Lone Tree, CO 80124
Phone (303) 265-3970

9695 S Yosemite St
Ste 224
Lone Tree, CO 80124
Phone (303) 265-3970

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

2221 Elm St
Rawlins, WY 82301
Phone (307) 324-2221

400 S 15th St
Worland, WY 82401
Phone (307) 347-3221

Interoperability endpoints

  • Direct secure messaging: elijah.grillo.1@17631.direct.athenahealth.com
  • Direct secure messaging: egrillo@yourcarecommunity.org
  • Direct secure messaging: elijah.grillo@hca3.eclinicaldirectplus.com

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1285029447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4123",
            "fax_number": "970-624-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9695 S YOSEMITE ST STE 224",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242890",
            "telephone_number": "303-265-3970",
            "fax_number": "303-265-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4102 Pinion Drive, 10th Medical Group",
            "address_2": "USAF Academy",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "80840",
            "country_code": "US",
            "telephone_number": "719-333-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "ELIJAH",
        "middle_name": "SEEGER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0059882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.