NPIMap

Individual provider Active NPI

Andrew Boulos, DO

  • Pulmonary Disease Physician
  • Pueblo, CO
National Provider Identifier
1689010100
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
DR.0058436 Issued in CO
Practice address
1600 N Grand Ave Ste 140
Pueblo, CO 81003-2755
Phone
(719) 564-1542
Fax
(719) 566-0916
NPI assigned
May 13, 2013
Last updated
Dec 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X DR.0058436 CO Primary

Addresses

Primary practice location

1600 N Grand Ave Ste 140
Pueblo, CO 81003-2755

Mailing address

2222 N Nevada Ave Ste 4004
Colorado Springs, CO 80907-6832
Phone (719) 471-7064

Other practice location 1

2222 N Nevada Ave Ste 4004
Colorado Springs, CO 80907-6832
Phone (719) 471-7064

Other practice location 2

400 N Pepper Ave Ste 204
Colton, CA 92324-1801
Phone (909) 580-6266

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
I20200724000701 CO Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0446548275 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Western University of Health Sciences College of Dental Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lutheran Hospital Association of the San Luis ValleyGroup PAC ID 4789589094, shared by 7 NPIs, 146 clinicians
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Salida Hospital DistrictGroup PAC ID 3577451152, shared by 9 NPIs, 100 clinicians

Practice addresses (Care Compare)

106 Blanca Ave
Alamosa, CO 81101-2340
Phone (719) 589-2511

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

28374 County Rd
Buena Vista, CO 81211-9158
Phone (719) 395-9048

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Hospital Association of the San Luis Valley CurrentSince Feb 1, 2026 Accepting new patients
Poudre Valley Medical Group, LLC Pulmonary Disease Current Accepting new patients
Lutheran Hospital Association of the San Luis Valley CurrentSince Feb 1, 2026 Accepting new patients
Poudre Valley Medical Group, LLC Pulmonary Disease CurrentSince Jun 1, 2025 Accepting new patients
Colorado Springs Pulmonary Consultants PC Pulmonary Disease CurrentSince Jul 27, 2020 Accepting new patients

Locations

106 Blanca Ave
Alamosa, CO 81101
Phone (719) 589-2511

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1725 E Boulder St
Ste 204
Colorado Springs, CO 80909
Phone (719) 365-6614

2222 N Nevada Ave
Ste 4004
Colorado Springs, CO 80907
Phone (719) 471-7064

2312 N Nevada Ave
Ste 305
Colorado Springs, CO 80907
Phone (719) 471-7064

310 County Road 14
Del Norte, CO 81132
Phone (719) 657-2510

19021 US Highway 285
La Jara, CO 81140
Phone (719) 274-5121

1600 N Grand Ave
Ste 140
Pueblo, CO 81003
Phone (719) 564-1542

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

58 Club Manor Dr
Pueblo, CO 81008
Phone (719) 584-4045

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

Interoperability endpoints

  • Direct secure messaging: aboulos@cspc.gwaydirect.com

Organizations & group practices 7

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1689010100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE STE 4004",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076832",
            "telephone_number": "719-471-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE STE 140",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032755",
            "telephone_number": "719-564-1542",
            "fax_number": "719-566-0916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 N Nevada Ave Ste 4004",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076832",
            "country_code": "US",
            "telephone_number": "719-471-7064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Pepper Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-6266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CO",
            "license": "DR.0058436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.