NPIMap

Individual provider Active NPI

Emily Ann Eickstaedt, AGNP

  • Gerontology Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1376214106
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APN.0996941-NP Issued in CO
Practice address
2502 E Pikes Peak Ave
Colorado Springs, CO 80909-6033
Phone
(719) 314-2327
NPI assigned
Sep 22, 2021
Last updated
May 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APN.0996941-NP CO
Gerontology Nurse Practitioner 363LG0600X APN.0996941-NP CO Primary
Primary Care Nurse Practitioner 363LP2300X APN.0996941-NP CO

Addresses

Primary practice location

2502 E Pikes Peak Ave
Colorado Springs, CO 80909-6033

Mailing address

2502 E Pikes Peak Ave
Colorado Springs, CO 80909-6033
Phone (719) 314-2327

Other practice location 1

2877 E Fountain Blvd
Colorado Springs, CO 80910-2312
Phone (719) 454-6009

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
I20250606001501 CO Practitioner - Nurse Practitioner 0840700100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2877 E Fountain Blvd
Oak Street Health Pikes Peak Park
Colorado Springs, CO 80910-2312
Phone (719) 454-6009

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918-2932
Phone (719) 454-6010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0996941-NPCOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Colorado, PLLC Current Accepting new patients
Oak Street Health Physicians Group of Colorado, PLLC CurrentSince Jul 21, 2025 Accepting new patients

Locations

2877 E Fountain Blvd
Colorado Springs, CO 80910
Phone (719) 454-6009

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone (719) 454-6010

Interoperability endpoints

  • Direct secure messaging: emily.eickstaedt@oakstreethealth.gwaydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1376214106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 E PIKES PEAK AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096033",
            "telephone_number": "719-314-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 E PIKES PEAK AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096033",
            "telephone_number": "719-314-2327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2877 E Fountain Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809102312",
            "country_code": "US",
            "telephone_number": "719-454-6009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EICKSTAEDT",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.0996941-NP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0996941-NP",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CO",
            "license": "APN.0996941-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.