Individual provider Active NPI

Walter Clinton West II, MD

  • Specialist
  • Pueblo, CO
National Provider Identifier
1528087962
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
26226 Issued in CO
Practice address
1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone
(719) 560-5656
Fax
(719) 560-4715
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 26226 CO Primary

Addresses

Primary practice location

1008 Minnequa Ave
Pueblo, CO 81004-3733

Mailing address

445 E Cheyenne Mountain Blvd Ste C PMB 406
Colorado Springs, CO 80906-4570
Phone (719) 538-8100

Other identifiers 3

IdentifierTypeStateIssuer
01262260MedicaidCO
2370237OtherCOAETNA
84145895001OtherCOPACIFICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120316000508 CO Practitioner - Emergency Medicine 7911980891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.89 of 100Reported as apm
Quality
86.88
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26226COMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Huerfano County Hospital District CurrentSince Jul 24, 2021 Accepting new patients
Huerfano County Hospital District CurrentSince Jul 24, 2021 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

23500 US Highway 160
Walsenburg, CO 81089
Phone (719) 738-5100

Interoperability endpoints

  • Direct secure messaging: walter.west.md@direct.sprhc.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1528087962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E CHEYENNE MOUNTAIN BLVD STE C PMB 406",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064570",
            "telephone_number": "719-538-8100",
            "fax_number": "719-538-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043733",
            "telephone_number": "719-560-5656",
            "fax_number": "719-560-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "WALTER",
        "middle_name": "CLINTON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "26226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01262260",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2370237",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "84145895001",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.