Individual provider Active NPI

Pamela Aubree Vanmierlo, M.D.

  • Occupational Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1851564975
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
DR.0061596 Issued in CO
Practice address
1035 Garden of the Gods Rd Ste 120
Colorado Springs, CO 80907-3416
Phone
(719) 365-3200
Fax
(719) 365-7680
NPI assigned
Apr 9, 2008
Last updated
Nov 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 19774 NV
Occupational Medicine Physician 2083X0100X DR.0061596 CO Primary

Addresses

Primary practice location

1035 Garden of the Gods Rd Ste 120
Colorado Springs, CO 80907-3416

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2417

Other practice location 1

975 Ryland St Ste 100
Reno, NV 89502-1669
Phone (775) 982-5000

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
I20231213002637 CO Practitioner - Preventive Medicine 2062634025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1035 Garden of the Gods Rd
Colorado Springs, CO 80907-9427
Phone (719) 329-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19774NVMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 8, 2024 Accepting new patients
Poudre Valley Medical Group, LLC Obstetrics & Gynecology CurrentSince Jan 8, 2024 Accepting new patients

Locations

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

4404 Barranca Ln
Ste 101
Castle Rock, CO 80104
Phone (720) 733-5260

1035 Garden of the Gods Rd
Ste 120
Colorado Springs, CO 80907
Phone (719) 329-1000

1035 Garden of the Gods Rd
Ste 120UCHMG
Colorado Springs, CO 80907
Phone (719) 329-1000

13445 Voyager Pkwy
Colorado Springs, CO 80921
Phone (719) 219-0333

2773 Janitell Rd
Colorado Springs, CO 80906
Phone (719) 365-6478

2999 New Center Pt
Colorado Springs, CO 80922
Phone (719) 364-6940

4323 Integrity Center Pt
Colorado Springs, CO 80917
Phone (719) 591-2558

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

11605 Meridian Market Vw
Ste 184
Peyton, CO 80831
Phone (719) 364-9555

Interoperability endpoints

  • Direct secure messaging: avanmierlo168043@ghc.direct-ci.net

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, 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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1851564975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-2417",
            "fax_number": "970-490-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 GARDEN OF THE GODS RD STE 120",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073416",
            "telephone_number": "719-365-3200",
            "fax_number": "719-365-7680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 Ryland St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021669",
            "country_code": "US",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-5225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANMIERLO",
        "first_name": "PAMELA",
        "middle_name": "AUBREE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NV",
            "license": "19774",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CO",
            "license": "DR.0061596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.