Individual provider Active NPI

Michael J Noble, MD

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1881656148
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28661 Issued in CO
Practice address
2405 Research Pkwy
Colorado Springs, CO 80920-1044
Phone
(719) 522-1133
Fax
(719) 264-1772
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28661 CO Primary

Addresses

Primary practice location

2405 Research Pkwy
Colorado Springs, CO 80920-1044

Mailing address

2405 Research Pkwy
Colorado Springs, CO 80920-1044
Phone (719) 522-1133

Other identifiers 1

IdentifierTypeStateIssuer
01286616MedicaidCO

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
I20100216001010 CO Practitioner - Internal Medicine 9931243896 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28661COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Colorado Medical Group LLC CurrentSince Jan 1, 2015 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Jan 1, 2015 Accepting new patients

Locations

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

1625 Medical Center Pt
Ste 200
Colorado Springs, CO 80907
Phone (719) 630-3276

6340 Barnes Rd
Colorado Springs, CO 80922
Phone (719) 570-0640

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

2405 Research Pkwy
Colorado Springs, CO 80920
Phone (719) 268-2800

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1881656148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 RESEARCH PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201044",
            "telephone_number": "719-522-1133",
            "fax_number": "719-264-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 RESEARCH PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201044",
            "telephone_number": "719-522-1133",
            "fax_number": "719-264-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "28661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01286616",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.