Andrew Boulos, DO
Individual provider Active NPI Pulmonary Disease Physician · Pueblo, CO
NPI 1689010100 · NPPES record last updated Dec 23, 2025
Key facts
- NPI
- 1689010100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- DR.0058436 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 25
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- 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 Valley
Poudre Valley Medical Group LLC
Salida Hospital District
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
- Centura Health-Penrose St Francis Health Services
- Uch-Memorial Health System
- San Luis Valley Regional Medical Center
- Heart of the Rockies Regional Medical Center
- St Mary-Corwin Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200724000701 | CO | Practitioner - Pulmonary Disease |
0446548275 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0058436 | CO | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Hospital Association of the San Luis Valley | Current |
Accepting new patients | |
| Colorado Springs Pulmonary Consultants PC | Pulmonary Disease | Current |
Accepting new patients |
| Lutheran Hospital Association of the San Luis Valley | Current |
Accepting new patients | |
| Poudre Valley Medical Group, LLC | Pulmonary Disease | Current | Accepting new patients |
| Poudre Valley Medical Group, LLC | Pulmonary Disease | Current |
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
2222 N Nevada Ave
Ste 4004
Colorado Springs, CO 80907
Phone (719) 471-7064
1725 E Boulder St
Ste 204
Colorado Springs, CO 80909
Phone (719) 365-6614
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
58 Club Manor Dr
Pueblo, CO 81008
Phone (719) 584-4045
1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760
1600 N Grand Ave
Ste 140
Pueblo, CO 81003
Phone (719) 564-1542
1000 Rush Dr
Salida, CO 81201
Phone (719) 530-2265
Interoperability endpoints
- aboulos@cspc.gwaydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | DR.0058436 | CO | Yes |
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
Other providers in Pueblo, CO
- Laura Borrego Gibbs
- Marlee Bos
- Kimberly Anne Boston
- Serenity Bouchard
- Genevieve C Boulay
- Sarah E Boulos
- Brianna C Bourne
- Cynthia Bower
- Nicole Bower
- Cathy Bowman
All providers in Pueblo, CO · Pulmonary Disease Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.