NPIMap

Individual provider Active NPI

Victoria Mallon, MD

  • Family Medicine Physician
  • Pueblo, CO
National Provider Identifier
1477580397
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39730 Issued in CO
Practice address
1300 Fortino Blvd
Pueblo, CO 81008-2077
Phone
(719) 404-5100
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albert Einstein College of Medicine of Yeshiva University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3210 N Academy Blvd
Suite 1
Colorado Springs, CO 80917-5158

999 17TH St
Suite 500
Denver, CO 80202-2728

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

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.
Opted out of Medicare
Yes, effective Oct 1, 2026 through Oct 1, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051020000128 CO Practitioner - Family Practice 6800812785 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39730COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Medical Group Colorado PLLC Family Medicine CurrentSince Feb 16, 2026 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Feb 1, 2020 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Feb 1, 2020 Accepting new patients
Inpatient Consultants of Colorado PC Family Medicine Past Accepting new patients
Inpatient Consultants of Colorado, PC Family Medicine Past Accepting new patients
Hospitalists of Pueblo Past Accepting new patients

Locations

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

8890 N Union Blvd
Ste 220
Colorado Springs, CO 80920
Phone (719) 574-9191

1633 Medical Center Pt
Fl 1
Colorado Springs, CO 80907
Phone (719) 667-4146

3210 N Academy Blvd
Ste 1
Colorado Springs, CO 80917
Phone (719) 591-4698

8890 N Union Blvd
Ste 200
Colorado Springs, CO 80920
Phone (719) 548-0700

999 17th St
Ste 500
Denver, CO 80202
Phone (720) 355-0539

Interoperability endpoints

  • Direct secure messaging: victoria.mallon.p4@direct.clinicafamilyhealth.nextgenshare.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39730 CO Primary

Addresses

NPPES NPI Registry

Primary practice location

1300 Fortino Blvd
Pueblo, CO 81008-2077

Mailing address

4651 Charlotte Park Dr Ste 300
Charlotte, NC 28217-1916
Phone (866) 808-6005

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
20631561MedicaidCO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 26, 2026.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1477580397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171916",
            "telephone_number": "866-808-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082077",
            "telephone_number": "719-404-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLON",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "39730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20631561",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.