Individual provider Active NPI

Matthew Richard Keysor, M.D.

  • Pediatrics Physician
  • Colorado Springs, CO
National Provider Identifier
1306827050
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR.0069527 Issued in CO
Practice address
4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075
Phone
(719) 632-4455
Fax
(719) 418-2128
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0069527 CO Primary

Addresses

Primary practice location

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075

Mailing address

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075
Phone (719) 632-4455

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
I20251021000547 CO Practitioner - Pediatric Medicine 3476770397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Maryland School of Medicine, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

999 17TH St
Suite 500
Denver, CO 80202-2723

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0069527COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Medical Group Colorado PLLC Pediatrics CurrentSince Oct 21, 2025 Accepting new patients

Locations

4150 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (719) 418-2121

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 364-4851

999 17th St
Ste 500
Denver, CO 80202
Phone (720) 355-0539

Interoperability endpoints

  • Direct secure messaging: matthew.keysor@mvmg.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1306827050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075",
            "telephone_number": "719-632-4455",
            "fax_number": "719-419-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075",
            "telephone_number": "719-632-4455",
            "fax_number": "719-418-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYSOR",
        "first_name": "MATTHEW",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0069527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.