NPIMap

Individual provider Active NPI

Muthanna Yacoub, M.D.

  • Family Medicine Physician
  • Woodland Park, CO
National Provider Identifier
1467834440
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0061892 Issued in CO
Practice address
16222 W US Highway 24 Ste 200
Woodland Park, CO 80863-8763
Phone
(719) 686-0878
Fax
(719) 365-7885
NPI assigned
Jun 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 DR.0061892 CO Primary

Addresses

Primary practice location

16222 W US Highway 24 Ste 200
Woodland Park, CO 80863-8763

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

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
I20190709000089 CO Practitioner - Family Practice 9234441841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2015
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)

16222 W US Hwy 24
Suite 200 Uchealth Family Medicine Woodla
Woodland Park, CO 80863-8763
Phone (719) 686-0878

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0061892COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Surgery CurrentSince Jul 11, 2022 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Jul 8, 2019 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Jul 8, 2019 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 11, 2022 Accepting new patients

Locations

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

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

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

1101 County Road 1
Cripple Creek, CO 80813
Phone (719) 650-1210

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

16222 W US Highway 24
Ste 200
Woodland Park, CO 80863
Phone (719) 686-0878

700 W US Highway 24
Woodland Park, CO 80863
Phone (719) 687-6022

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1467834440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16222 W US HIGHWAY 24 STE 200",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638763",
            "telephone_number": "719-686-0878",
            "fax_number": "719-365-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "MUTHANNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0061892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, CO

Sources for this page

Verify at the official NPI Registry.