Individual provider Active NPI

Madison Renee Desalvo, FNP-C

  • Family Nurse Practitioner
  • Denver, CO
National Provider Identifier
1699524967
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
C-APN.0102003-C-NP Issued in CO
Practice address
4859 Yampa St
Denver, CO 80249-7760
Phone
(303) 812-3940
NPI assigned
May 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X C-APN.0102003-C-NP CO Primary

Addresses

Primary practice location

4859 Yampa St
Denver, CO 80249-7760

Mailing address

221 S Garfield St Unit 108
Denver, CO 80209-3137
Phone (504) 303-1158

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628001241 CO Practitioner - Nurse Practitioner 1951845148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

  • Saint Joseph Hospital Hospital, Denver, CO, CCN 060028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
C-APN.0102003-C-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 15, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 15, 2024 Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885

Organizations & group practices 5

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 4

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": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1699524967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S GARFIELD ST UNIT 108",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093137",
            "telephone_number": "504-303-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 YAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802497760",
            "telephone_number": "303-812-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESALVO",
        "first_name": "MADISON",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0102003-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.