Individual provider Active NPI

Brian Grabert, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Colorado Springs, CO
National Provider Identifier
1750357414
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
20448 Issued in CO
Practice address
1633 Medical Center PT
Colorado Springs, CO 80907-8732
Phone
(719) 578-8666
Fax
(719) 667-4218
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician 2084D0003X DR0020448 CO
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 20448 CO Primary

Addresses

Primary practice location

1633 Medical Center PT
Colorado Springs, CO 80907-8732

Mailing address

1633 Medical Center PT
Colorado Springs, CO 80907-8732
Phone (719) 578-8666

Other identifiers 1

IdentifierTypeStateIssuer
01204486MedicaidCO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926001117 CO Practitioner - NeurologyPractitioner - Pediatric MedicinePractitioner - Neuropsychiatry 1850325051 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0020448COMDDiagnostic Neuroimaging (Psychiatry & Neurology) Physician
20448COMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Feb 19, 2018 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients

Locations

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

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

1400 E Boulder St
Ste 700
Colorado Springs, CO 80909
Phone (719) 365-7172

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1750357414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 MEDICAL CENTER PT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078732",
            "telephone_number": "719-578-8666",
            "fax_number": "719-667-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 MEDICAL CENTER PT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078732",
            "telephone_number": "719-578-8666",
            "fax_number": "719-667-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABERT",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": "CO",
            "license": "DR0020448",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CO",
            "license": "20448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01204486",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.