Individual provider Active NPI

Sharon Marie Pagdilao, NP

  • Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1902537962
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0995384-NP Issued in CO
Practice address
3425 Austin Bluffs Pkwy
Colorado Springs, CO 80918-5701
Phone
(719) 599-5753
NPI assigned
Jun 21, 2022
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0995384-NP CO Primary

Addresses

Primary practice location

3425 Austin Bluffs Pkwy
Colorado Springs, CO 80918-5701

Mailing address

2013 Collier Ave
Colorado Springs, CO 80909-2136
Phone (702) 767-4482

Other names 1

  • Sharon Marie Bullard 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
I20220906000715 CO Practitioner - Nurse Practitioner 5698159945 Reassigns benefits to 1 organization

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
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians
Luminosity Handw LLCGroup PAC ID 1456717883, 4 clinicians

Practice addresses (Care Compare)

406 E Grace Ave
Select Physical Therapy
Woodland Park, CO 80863-3127
Phone (719) 687-3767

6455 N Union Blvd
Suite 100
Colorado Springs, CO 80918-5852
Phone (719) 301-7246

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0995384-NPCOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminosity H&W LLC CurrentSince Feb 24, 2023 Accepting new patients

Locations

6455 N Union Blvd
Ste 100
Colorado Springs, CO 80918
Phone (303) 750-8100

Organizations & group practices 1

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": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1902537962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 COLLIER AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092136",
            "telephone_number": "702-767-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185701",
            "telephone_number": "719-599-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGDILAO",
        "first_name": "SHARON",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0995384-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "BULLARD",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.