Individual provider Active NPI

Larry Alan Gold, M.D.

  • Specialist
  • Colorado Springs, CO
National Provider Identifier
1972596815
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C022116 Issued in CO
Practice address
4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075
Phone
(719) 632-4455
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C022116 CO Primary

Addresses

Primary practice location

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075

Mailing address

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075
Phone (719) 632-4455

Other identifiers 1

IdentifierTypeStateIssuer
01221167MedicaidCO

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
I20121015000734 CO Practitioner - EndocrinologyPractitioner - Internal Medicine 0840456554 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C022116COMDSpecialist
PT011098GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews-Vu Medical Group, P.C. CurrentSince Jul 20, 2020 Accepting new patients
Matthews-Vu Medical Group, P.C. Current Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Jul 20, 2020 Accepting new patients

Locations

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 328-7971

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

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, 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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1972596815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075",
            "telephone_number": "719-632-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075",
            "telephone_number": "719-632-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "LARRY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "C022116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01221167",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.