Individual provider Active NPI

Lori Wertheimer, MD

  • Pediatrics Physician
  • Monument, CO
National Provider Identifier
1972543965
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
31067 Issued in CO
Practice address
192 Front St
Monument, CO 80132-6738
Phone
(719) 488-6998
Fax
(719) 488-8270
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 31067 CO Primary

Addresses

Primary practice location

192 Front St
Monument, CO 80132-6738

Mailing address

192 Front St
Monument, CO 80132-6738
Phone (719) 488-6998

Other identifiers 1

IdentifierTypeStateIssuer
01310671MedicaidCO

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
I20170302002077 CO Practitioner - Pediatric Medicine 6305073289 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31067COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Nov 4, 2021 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Feb 1, 2020 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Feb 1, 2020 Accepting new patients
Mountain View Medical Group, PC Past Accepting new patients

Locations

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

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

8890 N Union Blvd
Ste 220
Colorado Springs, CO 80920
Phone (719) 574-9191

9480 Briar Village Pt
Ste 200
Colorado Springs, CO 80920
Phone (719) 278-3627

8890 N Union Blvd
Ste 200
Colorado Springs, CO 80920
Phone (719) 548-0700

15909 Jackson Creek Pkwy
Monument, CO 80132
Phone (719) 481-0899

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1928/brand/1/csg/62/fhir/r4

Organizations & group practices 5

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972543965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 FRONT ST",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801326738",
            "telephone_number": "719-488-6998",
            "fax_number": "719-488-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 FRONT ST",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801326738",
            "telephone_number": "719-488-6998",
            "fax_number": "719-488-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTHEIMER",
        "first_name": "LORI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "31067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01310671",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monument, CO

Sources for this page

Verify at the official NPI Registry.