Individual provider Active NPI

Brian R Sandoval, MD

  • Anesthesiology Physician
  • Pueblo, CO
National Provider Identifier
1467457028
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35181 Issued in CO
Practice address
3404 Northridge Dr
Pueblo, CO 81008-1350
Phone
(719) 569-8015
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35181 CO Primary

Addresses

Primary practice location

3404 Northridge Dr
Pueblo, CO 81008-1350

Mailing address

3404 Northridge Dr
Pueblo, CO 81008-1350
Phone (719) 569-8015

Other identifiers 1

IdentifierTypeStateIssuer
01351816MedicaidCO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100810001118 CO Practitioner - Anesthesiology 7012816846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of New Mexico School of Medicine, 1992
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)

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35181COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Pathology Group, PC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Anesthesiology CurrentSince Jun 1, 2025 Accepting new patients
Matthew J Furman, D.O. LLC Pain Medicine Past Accepting new patients

Locations

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

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

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

408 N Main St
Fl 2
Pueblo, CO 81003
Phone (719) 584-4000

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

Organizations & group practices 4

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1467457028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 NORTHRIDGE DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081350",
            "telephone_number": "719-569-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 NORTHRIDGE DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081350",
            "telephone_number": "719-569-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "35181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01351816",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.