Individual provider Active NPI

Wendy A Bulow, PA

  • Physician Assistant
  • Pueblo, CO
National Provider Identifier
1376579540
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1675 Issued in CO
Practice address
110 E Routt
Pueblo, CO 81004
Phone
(719) 543-8711
Fax
(719) 543-5340
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1675 CO Primary

Addresses

Primary practice location

110 E Routt
Pueblo, CO 81004

Mailing address

310 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

Other identifiers 1

IdentifierTypeStateIssuer
85478075MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100607000460 CO Practitioner - Physician Assistant 6901936616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asthma and Allergy Associates, PCGroup PAC ID 2466341177, 11 clinicians

Practice addresses (Care Compare)

2709 N Tejon St
Colorado Springs, CO 80907-6231
Phone (719) 473-0872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1675COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Asthma & Allergy Associates, PC CurrentSince Apr 1, 2014 Accepting new patients
Asthma & Allergy Associates, PC Current Accepting new patients
Mountain View Medical Group, PC Medical Past Accepting new patients

Locations

1332 Bauer Ln
Canon City, CO 81212
Phone (719) 275-7485

595 Chapel Hills Dr
Ste 240
Colorado Springs, CO 80920
Phone (719) 364-4120

2709 N Tejon St
Colorado Springs, CO 80907
Phone (303) 473-0872

517 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-4016

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376579540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81004",
            "telephone_number": "719-543-8718",
            "fax_number": "719-543-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E ROUTT",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81004",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULOW",
        "first_name": "WENDY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85478075",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.