| Center Pointe Family Medicine Llc | |
|
37 Widefield Blvd Colorado Springs CO 80911-2126 | |
| (719) 390-4335 | |
| (719) 390-4566 |
| Full Name | Center Pointe Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 37 Widefield Blvd, Colorado Springs, Colorado |
| Authorized Official Name and Position | Baiju Abdulla (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 7193904335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center Pointe Family Medicine Llc 37 Widefield Blvd Colorado Springs CO 80911-2126 Ph: (719) 390-4335 | Center Pointe Family Medicine Llc 37 Widefield Blvd Colorado Springs CO 80911-2126 Ph: (719) 390-4335 |
| NPI Number | 1053654319 |
|---|---|
| Provider Enumeration Date | 04/04/2013 |
| Last Update Date | 05/03/2021 |
| Medicare PECOS PAC ID | 4688813090 |
|---|---|
| Medicare Enrollment ID | O20130615000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053654319 | NPI | - | NPPES |
| 15622819 | Medicaid | CO | |
| 06501575 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 27593 (Colorado) | Primary |
| Provider Name | Baiju Abdulla |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1316119076 PECOS PAC ID: 5890964324 Enrollment ID: I20120718000552 |
| Provider Name | Lois A Wenger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164747309 PECOS PAC ID: 7810136231 Enrollment ID: I20130615000172 |
| Provider Name | Aidan Kolbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821308255 PECOS PAC ID: 8628258753 Enrollment ID: I20150721000244 |
| Provider Name | Dana Ann Dawdy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740596303 PECOS PAC ID: 8325233992 Enrollment ID: I20180827002800 |
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