Individual provider Active NPI

Brendon Madrid, NP

  • Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1831616689
Registry record updated Aug 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
000000000 Issued in CO
Practice address
4112 Outlook Blvd Ste 325
Pueblo, CO 81008-1667
Phone
(719) 562-6300
NPI assigned
Aug 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 000000000 CO Primary

Addresses

Primary practice location

4112 Outlook Blvd Ste 325
Pueblo, CO 81008-1667

Mailing address

4112 Outlook Blvd Ste 325
Pueblo, CO 81008-1667
Phone (719) 562-6300

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
I20210426002351 CO Practitioner - Nurse Practitioner 5991113243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

1730 Blake St
Suite 100
Denver, CO 80202-1274
Phone (303) 296-2273

700 W Abriendo Ave
Pueblo, CO 81004-1546
Phone (719) 562-6300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000000000COMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Mar 29, 2021 Accepting new patients
American Current Care P.a. CurrentSince Mar 29, 2021 Accepting new patients

Locations

1730 Blake St
Ste 100
Denver, CO 80202
Phone (303) 296-2273

4112 Outlook Blvd
Ste 325
Pueblo, CO 81008
Phone (719) 562-6300

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1831616689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD STE 325",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-562-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD STE 325",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-562-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRID",
        "first_name": "BRENDON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.