NPIMap

Individual provider Active NPI

Rochelle Yvonne Elijah, M.D.

  • Family Medicine Physician
  • Pueblo, CO
National Provider Identifier
1376504654
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37357 Issued in CO
Practice address
3676 Parker Blvd
Pueblo, CO 81008-2212
Phone
(719) 553-2200
Fax
(719) 553-2216
NPI assigned
Mar 28, 2006
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37357 CO Primary

Addresses

Primary practice location

3676 Parker Blvd
Pueblo, CO 81008-2212

Mailing address

PO Box 9000
Pueblo, CO 81008-9000
Phone (719) 553-2200

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
I20040622000169 CO Practitioner - Family PracticePractitioner - Emergency Medicine 1355254541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Colorado Clinic PCGroup PAC ID 4284524067, 36 clinicians

Practice addresses (Care Compare)

3676 Parker Blvd
Suite 290
Pueblo, CO 81008-2214
Phone (719) 553-2200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37357COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Clinic PC CurrentSince Aug 1, 2004 Accepting new patients
Integrated Mobile Medical Suncrest Advanced Illness Management CurrentSince May 20, 2021 Accepting new patients
Beacon Medical Group, Inc. Family Medicine Past Accepting new patients
Beacon Medical Group, Inc. Family Medicine Past Accepting new patients
Knox Winamac Community Health Centers, Inc Family Medicine Past Accepting new patients
Beacon Medical Group, Inc. Family Medicine Past Accepting new patients

Locations

5700 S Quebec St
Ste 310
Greenwood Village, CO 80111
Phone (720) 941-5580

5950 S Willow Dr
Ste 306
Greenwood Village, CO 80111
Phone (720) 941-5580

3676 Parker Blvd
Pueblo, CO 81008
Phone (719) 253-7000

3676 Parker Blvd
Ste 260
Pueblo, CO 81008
Phone (719) 553-2201

3676 Parker Blvd
Ste 290
Pueblo, CO 81008
Phone (719) 553-2200

3676 Parker Blvd
Ste 370
Pueblo, CO 81008
Phone (719) 553-2209

206 N 2100 W
Ste 202
Slc, UT 84116
Phone (801) 325-0175

Interoperability endpoints

  • Direct secure messaging: rochelle.elijah.1@21306.direct.athenahealth.com

Organizations & group practices 6

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1376504654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9000",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810089000",
            "telephone_number": "719-553-2200",
            "fax_number": "719-553-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-553-2200",
            "fax_number": "719-553-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIJAH",
        "first_name": "ROCHELLE",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "37357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.