Individual provider Active NPI

Amos R Zimmermann, MD

  • Student in an Organized Health Care Education/Training Program
  • Charlottesville, VA
National Provider Identifier
1881199404
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0116037501 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-0001
Phone
(434) 924-2150
NPI assigned
Mar 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X DR.0074857 CO
Student in an Organized Health Care Education/Training Program 390200000X 0116037501 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-0001

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

Other practice location 1

1401 Court St
Pueblo, CO 81003-2715
Phone (719) 562-2300

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
I20250828003406 CO Practitioner - Vascular Surgery 7214285162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Virginia School of Medicine, 2025
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)

109 Latigo LN
Suite E
Canon City, CO 81212-8113
Phone (719) 562-2900

1401 Court St
Pueblo, CO 81003-2715
Phone (719) 562-2300

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)13
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0074857COMDVascular Surgery Physician
0116037501VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

109 Latigo Ln
Ste E
Canon City, CO 81212
Phone (719) 562-2900

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

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

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1401 Court St
Pueblo, CO 81003
Phone (719) 562-2300

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.

Hospital & facility affiliations 7

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1881199404",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-924-2150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Court St",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810032715",
            "country_code": "US",
            "telephone_number": "719-562-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "AMOS",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CO",
            "license": "DR.0074857",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116037501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.