Individual provider Active NPI

Brandi Lanae Trujillo, AGACNP, FNP

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1902435506
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0995320-NP Issued in CO
Practice address
3676 Parker Blvd Ste 260
Pueblo, CO 81008-2282
Phone
(719) 553-2201
NPI assigned
Apr 6, 2020
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0995320-NP CO Primary

Addresses

Primary practice location

3676 Parker Blvd Ste 260
Pueblo, CO 81008-2282

Mailing address

3107 E Spaulding Ave Unit 202
Pueblo, CO 81008-5219

Other names 1

  • Brandi Lanae Martinez Former name

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
I20200515000421 CO Practitioner - Nurse Practitioner 1951732569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Colorado Ave
Pueblo, CO 81004-2006
Phone (719) 543-8711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0995320-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Clinic PC CurrentSince Sep 7, 2020 Accepting new patients
Pueblo Community Health Center Inc CurrentSince Apr 14, 2024 Accepting new patients
Pueblo Community Health Center Inc CurrentSince Apr 14, 2024 Accepting new patients
Pueblo Community Health Center Inc. Past Accepting new patients

Locations

110 E Routt Ave
Pueblo, CO 81004
Phone (719) 543-8718

1301 E 7th St
Pueblo, CO 81001
Phone (719) 476-0220

300 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

3676 Parker Blvd
Pueblo, CO 81008
Phone (719) 253-7000

3676 Parker Blvd
Ste 260
Pueblo, CO 81008
Phone (719) 553-2201

3676 Parker Blvd
Ste 290
Pueblo, CO 81008
Phone (719) 553-2200

3937 Ivywood Ln
Pueblo, CO 81005
Phone (719) 553-0111

Interoperability endpoints

  • Direct secure messaging: brandi.trujillo.p1@direct.pueblochc.nextgenshare.com

Organizations & group practices 4

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1902435506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 E SPAULDING AVE UNIT 202",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810085219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD STE 260",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082282",
            "telephone_number": "719-553-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "BRANDI",
        "middle_name": "LANAE",
        "name_prefix": "Ms.",
        "credential": "AGACNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0995320-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDI",
            "last_name": "MARTINEZ",
            "middle_name": "LANAE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.