Individual provider Active NPI

Antonio Ramos, FNP-C

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1801957147
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
96765 Issued in CO
Practice address
4112 Outlook Blvd
Suite 37
Pueblo, CO 81008-1667
Phone
(719) 562-6254
Fax
(719) 562-6255
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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 96765 CO Primary

Addresses

Primary practice location

4112 Outlook Blvd
Suite 37
Pueblo, CO 81008-1667

Mailing address

4112 Outlook Blvd
Suite 37
Pueblo, CO 81008-1667
Phone (719) 562-6254

Other identifiers 1

IdentifierTypeStateIssuer
533790004MedicaidCO

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
I20070425000029 CO Practitioner - Nurse Practitioner 8921103656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone (719) 557-4221

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

4112 Outlook Blvd
Pueblo, CO 81008-1667

Hospital & facility affiliations

  • St Mary-Corwin Hospital Hospital, Pueblo, CO, CCN 060012

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
96765COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Sep 1, 2010 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Sep 1, 2010 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

1008 Minnequa Ave
#1501
Pueblo, CO 81004
Phone (719) 564-0390

4112 Outlook Blvd
Ste 37
Pueblo, CO 81008
Phone (719) 562-6254

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 4

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 3

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1801957147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD",
            "address_2": "SUITE 37",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-562-6254",
            "fax_number": "719-562-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD",
            "address_2": "SUITE 37",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-562-6254",
            "fax_number": "719-562-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "ANTONIO",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "96765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "533790004",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.