Individual provider Active NPI

Julie A Newburg, M.D.

  • Otolaryngology Physician
  • Pueblo, CO
National Provider Identifier
1740234467
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
43188 Issued in CO
Practice address
1304 N Grand Ave
Pueblo, CO 81003-2759
Phone
(719) 544-3752
Fax
(719) 542-1794
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 43188 CO Primary

Addresses

Primary practice location

1304 N Grand Ave
Pueblo, CO 81003-2759

Mailing address

3723 Augusta LN
Pueblo, CO 81001-4918
Phone (719) 544-1831

Other identifiers 1

IdentifierTypeStateIssuer
52280322MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13906SCMDSocial Worker
43188COMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkwest Surgery Center, LLC. PastSince Oct 18, 2013 Accepting new patients
ENT Clinic of Pueblo Prof LLC Otolaryngology PastSince Jun 10, 2005 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1740234467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 AUGUSTA LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810014918",
            "telephone_number": "719-544-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032759",
            "telephone_number": "719-544-3752",
            "fax_number": "719-542-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBURG",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "43188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52280322",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.