NPIMap

Individual provider Active NPI

Andrea Nicolette Manhart, D. O,

  • Neurology Physician
  • Colorado Springs, CO
National Provider Identifier
1326373952
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DR.0061627 Issued in CO
Practice address
4110 Briargate Pkwy Ste 405
Colorado Springs, CO 80920-7838
Phone
(719) 365-7300
Fax
(719) 365-7301
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DR.0061627 CO Primary
Neurology Physician 2084N0400X 58.003193 OH

Addresses

Primary practice location

4110 Briargate Pkwy Ste 405
Colorado Springs, CO 80920-7838

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4034

Other practice location 1

630 W Main St Ste 101
Wilmington, OH 45177-2171
Phone (937) 283-2570

Other identifiers 2

IdentifierTypeStateIssuer
89318MedicaidOH
34.010718OtherOHMEDICAL LICENSE

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
I20190228001278 CO Practitioner - Neurology 8729228051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2009
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)

1400 E Boulder St
Suite 700 Uchmg Cardio/Cardiac Surg Col
Colorado Springs, CO 80909-5533
Phone (719) 635-7172

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0061627COMDNeurology Physician
58.003193OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Apr 8, 2019 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Apr 8, 2019 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4110 Briargate Pkwy
Ste 405
Colorado Springs, CO 80920
Phone (719) 365-7300

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

4110 Briargate Pkwy
Ste 140
Colorado Springs, CO 80920
Phone (719) 365-7300

1400 E Boulder St
Ste 700
Colorado Springs, CO 80909
Phone (719) 365-7172

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

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 and National Provider Directory roles.

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1326373952",
    "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": "970-624-4034",
            "fax_number": "970-490-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY STE 405",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207838",
            "telephone_number": "719-365-7300",
            "fax_number": "719-365-7301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 W Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "OH",
            "postal_code": "451772171",
            "country_code": "US",
            "telephone_number": "937-283-2570",
            "fax_number": "937-283-2573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANHART",
        "first_name": "ANDREA",
        "middle_name": "NICOLETTE",
        "name_prefix": "Dr.",
        "credential": "D. O,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0061627",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "58.003193",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89318",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "34.010718",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.