Organization Active NPI

Ronald W Pelton MD PHD PC

  • Ophthalmology Physician
  • Colorado Springs, CO
National Provider Identifier
1306875455
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RONALD W PELTON MD PHD PC
Practice address
2770 N Union Blvd
Suite 100
Colorado Springs, CO 80909-1120
Phone
(719) 329-0040
Fax
(719) 329-0080
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Rosa M Tellez
Title
Office Manager
Phone
(719) 329-0040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2770 N Union Blvd
Suite 100
Colorado Springs, CO 80909-1120

Mailing address

2770 N Union Blvd
Suite 100
Colorado Springs, CO 80909-1120
Phone (719) 329-0040

Other identifiers 2

IdentifierTypeStateIssuer
97632082MedicaidCO
70722382MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050609000831 CO Part B Supplier - Clinic/Group Practice 8921041955 Receives reassigned benefits from 2 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

2770 N Union Blvd
Ste 100
Colorado Springs, CO 80909
Phone (719) 329-0040

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1306875455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 N UNION BLVD",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091120",
            "telephone_number": "719-329-0040",
            "fax_number": "719-329-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 N UNION BLVD",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091120",
            "telephone_number": "719-329-0040",
            "fax_number": "719-329-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD W PELTON MD PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "TELLEZ",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-329-0040"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97632082",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70722382",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.