NPIMap

Individual provider Active NPI

Samuel A Piedad Jr., M.D.

  • Internal Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1295732493
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40409 Issued in CO
Practice address
2920 N Cascade Ave
Ste 201
Colorado Springs, CO 80907-6264
Phone
(719) 227-0027
Fax
(719) 955-4958
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X DR.0040409 CO
Internal Medicine Physician 207R00000X 40409 CO Primary

Addresses

Primary practice location

2920 N Cascade Ave
Ste 201
Colorado Springs, CO 80907-6264

Mailing address

2920 N Cascade Ave
Ste 201
Colorado Springs, CO 80907-6264
Phone (719) 227-0027

Other identifiers 1

IdentifierTypeStateIssuer
46281312MedicaidCO

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
I20070802000396 CO Practitioner - Internal MedicinePractitioner - Nephrology 5294826442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pankaj Nashikkar MD LLCGroup PAC ID 5597057828, 2 clinicians

Practice addresses (Care Compare)

2920 N Cascade Ave
Suite 201
Colorado Springs, CO 80907-6264
Phone (719) 232-1939

Hospital & facility affiliations

  • 062594-Liberty Dialysis-Colorado Springs West Dialysis facility, Colorado Springs, CO, CCN 062594
  • 062564 Liberty Dialysis - Colorado Springs South (FMC) Dialysis facility, Colorado Springs, CO, CCN 062564
  • HCA Healthone Hospice & Family Care Hospice, Greenwood Village, CO, CCN 061573
  • Bristol Hospice - Denver Hospice, Greenwood Village, CO, CCN 061576
  • Optimal Hospice Care Hospice, Denver, CO, CCN 061568
  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031
  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020
  • St Francis Hospital - Interquest Hospital, Colorado Springs, CO, CCN 060133
  • Center at Centennial, the Nursing home, Colorado Springs, CO, CCN 065390
  • Center at Park West LLC, the Nursing home, Pueblo, CO, CCN 065427

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40409COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pankaj Nashikkar MD LLC Internal Medicine CurrentSince Aug 1, 2016 Accepting new patients

Locations

2222 N Nevada Ave
Ste 5003
Colorado Springs, CO 80907
Phone (719) 227-0027

2920 N Cascade Ave
Ste 201
Colorado Springs, CO 80907
Phone (719) 227-0027

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 and National Provider Directory roles.

Hospital & facility affiliations 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1295732493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE",
            "address_2": "STE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076264",
            "telephone_number": "719-227-0027",
            "fax_number": "719-955-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE",
            "address_2": "STE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076264",
            "telephone_number": "719-227-0027",
            "fax_number": "719-955-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEDAD",
        "first_name": "SAMUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "DR.0040409",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "40409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46281312",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.