NPIMap

Individual provider Active NPI

Maria Vanushkina

  • Interventional Pain Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1497133987
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
DR.0060400 Issued in CO
Practice address
4110 Briargate Pkwy Ste 100B
Colorado Springs, CO 80920-7836
Phone
(719) 364-0160
NPI assigned
May 15, 2015
Last updated
Jul 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X DR.0060400 CO Primary

Addresses

Primary practice location

4110 Briargate Pkwy Ste 100B
Colorado Springs, CO 80920-7836

Mailing address

601 Elmwood Ave Box 664
Rochester, NY 14642-0001
Phone (585) 275-3274

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
I20200928000564 CO Practitioner - Physical Medicine and Rehabilitation 1951695477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Albany Medical College of Union University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

4110 Briargate Pkwy
Colorado Springs, CO 80920-7835
Phone (719) 364-0160

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Physical Medicine & Rehabilitation CurrentSince Sep 20, 2020 Accepting new patients
Poudre Valley Medical Group, LLC Physical Medicine & Rehabilitation CurrentSince Sep 20, 2020 Accepting new patients
University of Rochester Physical Medicine and Rehabilitation Physical Medicine & Rehabilitation PastSince Aug 25, 2019 Accepting new patients

Locations

4110 Briargate Pkwy
Ste 100
Colorado Springs, CO 80920
Phone (719) 364-0160

4110 Briargate Pkwy
Ste 100B
Colorado Springs, CO 80920
Phone (719) 364-0160

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1497133987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 664",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY STE 100B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207836",
            "telephone_number": "719-364-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANUSHKINA",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-15",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CO",
            "license": "DR.0060400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.