Active NPI
Michelle Rene Kowalis, D.O.
- Internal Medicine Physician
- Pueblo, CO
National Provider Identifier
1932460185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4182
- Practice address
- 400 W 16TH St
Pueblo, CO 81003-2745 - Phone
- (719) 584-4000
- NPI assigned
- Jun 5, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4182 | CO | Primary |
Addresses
Primary practice location
400 W 16TH St
Pueblo, CO 81003-2745
Mailing address
400 W 16TH St
Pueblo, CO 81003-2745
Other names 1
- Michelle Rene Andrews
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150812007414 | CO | Practitioner - Internal Medicine | 4880834423 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3676 Parker Blvd
Pueblo, CO 81008-2213
4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260
Hospital & facility affiliations
- Centerwell Home Health
- Adoration Home Health
- Parkview Medical Center, Inc
- St Mary-Corwin Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4182 | CO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Pueblo Pathology Group, PC | Current | Accepting new patients |
Locations
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633
3676 Parker Blvd
Ste 110
Pueblo, CO 81008
Phone (719) 253-7102
1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760
400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000
Organizations & group practices 3
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.
-
- General Practice Physician
- Loveland, CO
- NPI 1366763260
-
- Anatomic Pathology & Clinical Pathology Physician
- Pueblo, CO
- NPI 1275690588
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Nursing Facility/Intermediate Care Facility
- Pueblo, CO
- NPI 1942391487
Hospital
-
- Home Health Agency
- Colorado Springs, CO
- NPI 1346408762
-
- Home Health Agency
- Pueblo, CO
- NPI 1093126781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1932460185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W 16TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W 16TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032745",
"telephone_number": "719-584-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOWALIS",
"first_name": "MICHELLE",
"middle_name": "RENE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-05",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "4182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELLE",
"last_name": "ANDREWS",
"middle_name": "RENE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.