Individual provider Active NPI

Andrew Maximus Macedo

  • Physical Therapy Assistant
  • Colorado Springs, CO
National Provider Identifier
1558284885
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
0015869 Issued in CO
Practice address
4105 Briargate Pkwy Ste 300B
Colorado Springs, CO 80920-3487
Phone
(719) 600-2075
NPI assigned
Aug 3, 2026
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0015869 CO Primary

Addresses

Primary practice location

4105 Briargate Pkwy Ste 300B
Colorado Springs, CO 80920-3487

Mailing address

5763 Kent Creek LN
Colorado Springs, CO 80924-8130
Phone (719) 354-3929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0015869COMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1558284885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5763 KENT CREEK LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809248130",
            "telephone_number": "719-354-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 BRIARGATE PKWY STE 300B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203487",
            "telephone_number": "719-600-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEDO",
        "first_name": "ANDREW",
        "middle_name": "MAXIMUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "0015869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.