Individual provider Active NPI

Bruce P Machaffie, M.D.

  • Pediatrics Physician
  • Colorado Springs, CO
National Provider Identifier
1871595173
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33164 Issued in CO
Practice address
3205 N Academy Blvd Ste 100
Colorado Springs, CO 80917
Phone
(719) 632-5700
NPI assigned
Jun 1, 2005
Last updated
Jun 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 33164 CO Primary

Addresses

Primary practice location

3205 N Academy Blvd Ste 100
Colorado Springs, CO 80917

Mailing address

3205 N Academy Blvd Ste 130
Colorado Springs, CO 80917-5152
Phone (719) 632-5700

Other practice location 1

6190 Barnes Rd
Colorado Springs, CO 80922-2600
Phone (719) 596-4502

Other practice location 2

6190 Barnes Rd
Colorado Springs, CO 80922-2600
Phone (719) 596-4502

Other identifiers 1

IdentifierTypeStateIssuer
01331644MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33164COMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1871595173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175152",
            "telephone_number": "719-632-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80917",
            "telephone_number": "719-632-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6190 Barnes Rd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809222600",
            "country_code": "US",
            "telephone_number": "719-596-4502",
            "fax_number": "719-597-2668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6190 Barnes Rd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809222600",
            "country_code": "US",
            "telephone_number": "719-596-4502",
            "fax_number": "719-597-2668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACHAFFIE",
        "first_name": "BRUCE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "33164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01331644",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.