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Individual provider Active NPI

Kevin Leonard McClintock, M.D.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Pueblo, CO
National Provider Identifier
1366400178
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
DR.0035456 Issued in CO
Practice address
1207 Pueblo Boulevard Way
Pueblo, CO 81005-2175
Phone
(195) 420-0327
Fax
(719) 542-1413
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35456 CO
Hospitalist Physician 208M00000X DR.0035456 CO
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X DR.0035456 CO Primary

Addresses

Primary practice location

1207 Pueblo Boulevard Way
Pueblo, CO 81005-2175

Mailing address

801 West Colorado Ave
Trinidad, CO 81082-1319
Phone (719) 846-3133

Other practice location 1

1107 Pueblo Boulevard Way
Pueblo, CO 81005-1595
Phone (719) 542-0032

Other practice location 2

1502 E Main St Ste 1
Trinidad, CO 81082-2014
Phone (719) 846-3060

Other identifiers 1

IdentifierTypeStateIssuer
01354562MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NM2 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
I20040113000460 CO Practitioner - Emergency MedicinePractitioner - General Practice 6608776729 Reassigns benefits to 2 organizations
I20100126000128 NM Practitioner - Emergency MedicinePractitioner - General PracticePractitioner - Family Practice 6608776729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice, General Practice
Education
University of Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinidad Area Health AssociationGroup PAC ID 2769394055, shared by 2 NPIs, 28 clinicians

Practice addresses (Care Compare)

400 Benedicta Ave
Suite a
Trinidad, CO 81082-2089
Phone (719) 846-2206

410 Benedicta Ave
Trinidad, CO 81082-2005
Phone (719) 846-9213

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.05 of 100Reported as group
Quality
84.23
Promoting interoperability
100
Improvement activities
40
Cost
51.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35456COMDEmergency Medicine Physician
DR.0035456COMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinidad Area Health Association Hospice and Palliative Medicine CurrentSince Jun 24, 2010 Accepting new patients
Hospital Care Consultants Region II Inc CurrentSince Oct 14, 2011 Accepting new patients
Emergency Staffing Solutions Inc Emergency Medicine CurrentSince Oct 14, 2011 Accepting new patients
Trinidad Area Health Association CurrentSince Dec 1, 2025 Accepting new patients
Huerfano County Hospital District Hospice and Palliative Medicine Current Accepting new patients
Trinidad Area Health Association CurrentSince Jun 24, 2010 Accepting new patients
Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Walsen Clinic Past Accepting new patients

Locations

400 Benedicta Ave
Ste A
Trinidad, CO 81082
Phone (719) 846-2206

410 Benedicta Ave
Trinidad, CO 81082
Phone (719) 846-8051

23500 US Highway 160
Walsenburg, CO 81089
Phone (719) 738-5100

900 W Ash St
Deming, NM 88030
Phone (505) 546-2761

203 Hospital Dr
Raton, NM 87740
Phone (505) 445-2741

800 E 9th Ave
Truth Or Consequences, NM 87901
Phone (505) 743-1270

Interoperability endpoints

  • Direct secure messaging: kevin_mcclintock@yourcarecommunity.org
  • Direct secure messaging: kevin.mcclintock.1@5071.direct.athenahealth.com

Organizations & group practices 8

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1366400178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WEST COLORADO AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810821319",
            "telephone_number": "719-846-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 PUEBLO BOULEVARD WAY",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052175",
            "telephone_number": "195-420-0327",
            "fax_number": "719-542-1413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 Pueblo Boulevard Way",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810051595",
            "country_code": "US",
            "telephone_number": "719-542-0032",
            "fax_number": "719-542-1413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1502 E Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Trinidad",
            "state": "CO",
            "postal_code": "810822014",
            "country_code": "US",
            "telephone_number": "719-846-3060",
            "fax_number": "719-422-8358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "KEVIN",
        "middle_name": "LEONARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "35456",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0035456",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CO",
            "license": "DR.0035456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01354562",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.