NPIMap

Individual provider Active NPI

Matthew Blum, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Colorado Springs, CO
National Provider Identifier
1659348480
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
48455 Issued in CO
Practice address
525 N Foote Ave
Suite 302
Colorado Springs, CO 80909-4501
Phone
(719) 365-5445
Fax
(719) 365-5530
NPI assigned
Mar 1, 2006
Last updated
Feb 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 48455 CO Primary

Addresses

Primary practice location

525 N Foote Ave
Suite 302
Colorado Springs, CO 80909-4501

Mailing address

2695 Rocky Mountain Ave
Suite 150
Loveland, CO 80538-8702
Phone (970) 624-4443

Other identifiers 1

IdentifierTypeStateIssuer
78658861MedicaidCO

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
I20100521000558 CO Practitioner - Thoracic Surgery 6305975848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Johns Hopkins University School of Medicine, 1992
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)

1400 E Boulder
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

525 Bob Peters GRV
Colorado Springs, CO 80909-4533
Phone (719) 365-6800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48455COMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Mar 1, 2013 Accepting new patients
Northwestern Medical Faculty Foundation Current Accepting new patients
Poudre Valley Medical Group, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Mar 1, 2013 Accepting new patients
Uch-MHS Past Accepting new patients

Locations

1400 E Boulder St
Ste 600
Colorado Springs, CO 80909
Phone (719) 364-6487

525 Bob Peters Grv
Ste 302
Colorado Springs, CO 80909
Phone (719) 365-5134

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1000 Rush Dr
Salida, CO 81201
Phone (719) 530-2265

Dept 5777
Carol Stream, IL 60122

Organizations & group practices 4

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1659348480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702",
            "telephone_number": "970-624-4443",
            "fax_number": "970-490-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N FOOTE AVE",
            "address_2": "SUITE 302",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094501",
            "telephone_number": "719-365-5445",
            "fax_number": "719-365-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CO",
            "license": "48455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78658861",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.