NPIMap

Organization Active NPI

Matthews-Vu Medical Group, PC

  • Clinical Pathology/Laboratory Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1699367375
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
Legal business name
MATTHEWS-VU MEDICAL GROUP, PC
Practice address
1715 N Weber St Ste 130
Colorado Springs, CO 80907-7524
Phone
(719) 633-5660
NPI assigned
Feb 4, 2021
Last updated
Feb 12, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MATTHEWS-VU MEDICAL GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Authorized official

Name
Kate Bogue
Title
Credentialing
Phone
(719) 632-4455

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X NU Primary

Addresses

Primary practice location

1715 N Weber St Ste 130
Colorado Springs, CO 80907-7524

Mailing address

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110603000138 CO Part B Supplier - Clinic/Group Practice 3072790864 Receives reassigned benefits from 111 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colorado Springs, CO

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Matthews-Vu Medical Group P13 organizations share this tax ID, including this one
Part of
Matthews-Vu Medical Group P

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1715 N Weber St
Ste 130
Colorado Springs, CO 80907
Phone (719) 633-5660

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 328-7971

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1699367375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 N WEBER ST STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077524",
            "telephone_number": "719-633-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEWS-VU MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MATTHEWS-VU MEDICAL GROUP, PC",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "BOGUE",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "719-632-4455"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.