NPIMap

Individual provider Active NPI

Theodore Joseph Puls, M.D.

  • Family Medicine Physician
  • Pueblo, CO
National Provider Identifier
1588643290
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23941 Issued in CO
Practice address
1619 N Greenwood St
Suite 208
Pueblo, CO 81003-2644
Phone
(719) 561-4336
Fax
(719) 561-8469
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23941 CO Primary
Legal Medicine 173000000X 29341 CO

Addresses

Primary practice location

1619 N Greenwood St
Suite 208
Pueblo, CO 81003-2644

Mailing address

1619 N Greenwood St
Suite 208
Pueblo, CO 81003-2644
Phone (719) 561-4336

Other identifiers 1

IdentifierTypeStateIssuer
01293414MedicaidCO

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
I20040524000982 CO Practitioner - Family Practice 2466443791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 1986
Medicare assignment
May accept Medicare assignment
Group practices
Ted J Puls MD PCGroup PAC ID 5294703831, 3 clinicians

Practice addresses (Care Compare)

1619 N Greenwood St
Suite 208
Pueblo, CO 81003-2656

Hospital & facility affiliations

  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020
  • St Mary-Corwin Hospital Hospital, Pueblo, CO, CCN 060012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29341COMDLegal Medicine
23941COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ted J Puls MD PC Family Medicine CurrentSince Aug 1, 1996 Accepting new patients

Locations

1619 N Greenwood St
Ste 208
Pueblo, CO 81003
Phone (719) 543-6633

1316 N Grand Ave
Pueblo, CO 81003
Phone (719) 583-9050

1619 N Greenwood St
Pueblo, CO 81003
Phone (719) 542-9010

Organizations & group practices 1

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1588643290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 N GREENWOOD ST",
            "address_2": "SUITE 208",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032644",
            "telephone_number": "719-561-4336",
            "fax_number": "719-561-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 N GREENWOOD ST",
            "address_2": "SUITE 208",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032644",
            "telephone_number": "719-561-4336",
            "fax_number": "719-561-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULS",
        "first_name": "THEODORE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "23941",
            "primary": true
        },
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CO",
            "license": "29341",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01293414",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.