Individual provider Active NPI

Nida Firdous, M.D

  • Internal Medicine Physician
  • Pueblo, CO
National Provider Identifier
1699200535
Registry record updated Jul 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR0064812 Issued in CO
Practice address
400 W 16TH St # 105
Pueblo, CO 81003-2781
Phone
(719) 584-4000
NPI assigned
Apr 28, 2017
Reactivated
Dec 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR0064812 CO Primary

Addresses

Primary practice location

400 W 16TH St # 105
Pueblo, CO 81003-2781

Mailing address

400 W 16TH St # 105
Pueblo, CO 81003-2781
Phone (719) 584-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200820003201 CO Practitioner - Hospitalist 0244656213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

Hospital & facility affiliations

  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0064812COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Pueblo Pathology Group, PC Current Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients

Locations

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

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

400 W 16th St
#105
Pueblo, CO 81003
Phone (719) 584-4000

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

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.

Hospital & facility affiliations 7

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": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593734400000",
    "number": "1699200535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST # 105",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032781",
            "telephone_number": "719-584-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST # 105",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032781",
            "telephone_number": "719-584-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIRDOUS",
        "first_name": "NIDA",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "deactivation_date": "2017-12-04",
        "reactivation_date": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR0064812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.