Individual provider Active NPI

Martha Dambrosio MD

  • Rheumatology Physician
  • Colorado Springs, CO
National Provider Identifier
1659370427
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
32478 Issued in CO
Practice address
8295 Old Exchange Dr
Colorado Springs, CO 80920-4811
Phone
(719) 535-8075
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 32478 CO Primary

Addresses

Primary practice location

8295 Old Exchange Dr
Colorado Springs, CO 80920-4811

Mailing address

8295 Old Exchange Dr
Colorado Springs, CO 80920-4811
Phone (719) 535-8075

Other identifiers 3

IdentifierTypeStateIssuer
01324789MedicaidCO
DS2136OtherCORR MCR PTAN
660000507OtherCORRMCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170927004533 SD Practitioner - Internal MedicinePractitioner - Rheumatology 8224220348 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32478COMDRheumatology Physician
1039SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Aug 9, 2017 Accepting new patients
Rapid City Regional Hospital Inc CurrentSince Aug 9, 2017 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1659370427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8295 OLD EXCHANGE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204811",
            "telephone_number": "719-535-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8295 OLD EXCHANGE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204811",
            "telephone_number": "719-535-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMBROSIO MD",
        "first_name": "MARTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CO",
            "license": "32478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01324789",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR PTAN",
            "identifier": "DS2136",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "660000507",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.