Individual provider Active NPI

Andrew R Ellias, D.O.

  • Internal Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1740386861
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28329 Issued in CO
Practice address
675 Southpointe CT
Ste 101
Colorado Springs, CO 80906-3887
Phone
(719) 540-5700
Fax
(719) 540-5702
NPI assigned
Sep 16, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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 28329 CO Primary

Addresses

Primary practice location

675 Southpointe CT
Ste 101
Colorado Springs, CO 80906-3887

Mailing address

675 Southpointe CT
Ste 101
Colorado Springs, CO 80906-3887
Phone (719) 540-5700

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
28329COMDInternal Medicine Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1740386861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 SOUTHPOINTE CT",
            "address_2": "STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063887",
            "telephone_number": "719-540-5700",
            "fax_number": "719-540-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 SOUTHPOINTE CT",
            "address_2": "STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063887",
            "telephone_number": "719-540-5700",
            "fax_number": "719-540-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIAS",
        "first_name": "ANDREW",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "28329",
            "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 Oct 22, 2007; 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.