NPIMap

Individual provider Active NPI

Gina C Bamberger, D.O.

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1376681213
Registry record updated Oct 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36186 Issued in CO
Practice address
1730 N Corona St
Colorado Springs, CO 80907-7644
Phone
(719) 365-7100
Fax
(719) 365-7109
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2016

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 36186 CO Primary

Addresses

Primary practice location

1730 N Corona St
Colorado Springs, CO 80907-7644

Mailing address

1730 N Corona St
Colorado Springs, CO 80907-7644
Phone (719) 365-7100

Other identifiers 1

IdentifierTypeStateIssuer
01361864MedicaidCO

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
I20090227000201 CO Practitioner - Family Practice 3375609324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

320 E Fontanero St
Suite 100 Uchealth Primary Care Fontanero
Colorado Springs, CO 80907-7535
Phone (719) 365-7420

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36186COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Oct 1, 2012 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Oct 1, 2012 Accepting new patients
Southern Colorado Medical Associates Family Medicine Past Accepting new patients

Locations

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

1730 N Corona St
Colorado Springs, CO 80907
Phone (719) 365-7100

320 E Fontanero St
Ste 100
Colorado Springs, CO 80907
Phone (719) 327-5660

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

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

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

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475280000000",
    "number": "1376681213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 N CORONA ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077644",
            "telephone_number": "719-365-7100",
            "fax_number": "719-365-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 N CORONA ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077644",
            "telephone_number": "719-365-7100",
            "fax_number": "719-365-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBERGER",
        "first_name": "GINA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2016-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "36186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01361864",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.