NPIMap

Individual provider Active NPI

Matthew Petrie, M.D.

  • Anesthesiology Physician
  • Colorado Springs, CO
National Provider Identifier
1467719054
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DR.0058743 Issued in CO
Practice address
1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533
Phone
(719) 365-6999
Fax
(719) 365-2837
NPI assigned
Apr 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD2016-0252 NM
Anesthesiology Physician 207L00000X DR.0058743 CO Primary

Addresses

Primary practice location

1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533

Mailing address

1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533
Phone (719) 365-6999

Other practice location 1

MSC 10 6000
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-2610

Other identifiers 1

IdentifierTypeStateIssuer
63235OtherNYALBANY MEDICAL CENTER

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
I20170907000775 CO Practitioner - Anesthesiology 6305119728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
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)

1400 E Boulder St
Suite 2508
Colorado Springs, CO 80909-5533
Phone (719) 365-6999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0058743COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Anesthesiology CurrentSince Dec 27, 2017 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Dec 27, 2017 Accepting new patients

Locations

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

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

1400 E Boulder St
Ste 1183
Colorado Springs, CO 80909
Phone (719) 365-6999

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

1400 E Boulder St
Ste 2508
Colorado Springs, CO 80909
Phone (719) 365-1292

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

58 Club Manor Dr
Pueblo, CO 81008
Phone (719) 584-4045

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

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 and National Provider Directory roles.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1467719054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 2508",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-6999",
            "fax_number": "719-365-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 2508",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-6999",
            "fax_number": "719-365-2837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "MSC 10 6000",
            "address_2": "1 University of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-2610",
            "fax_number": "505-272-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-19",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NM",
            "license": "MD2016-0252",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR.0058743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALBANY MEDICAL CENTER",
            "identifier": "63235",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.