Matthew D Pouliot (NPI# 1154584266, PAC ID# 4486684164) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1154584266 |
| PAC ID by PECOS | 4486684164 |
| Professional Enrollment ID | I20100106000501 |
| Full Name | Matthew D Pouliot |
| Organization Legal Name | FRONT RANGE PAIN MEDICINE LLC |
| Address |
3744 S Timberline Rd Suite 102 Fort Collins CO 80525-4334 |
| Phone Number | 9704950506 |
| Gender | M |
| Credential | DO |
| Graduation Year | 2004 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Secondary Specialties | OSTEOPATHIC MANIPULATIVE MEDICINE, PAIN MANAGEMENT |
| Group Practice PAC ID | 7113095449 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 281361 | LEXINGTON REGIONAL HEALTH CENTER |
| 281360 | BOX BUTTE GENERAL HOSPITAL |
| 060119 | MEDICAL CENTER OF THE ROCKIES |
| 060010 | POUDRE VALLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4108 Laramie St, Cheyenne, WY 82001-1969 | 9704950506 | FRONT RANGE PAIN MEDICINE LLC |
| 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 | 9704950506 | FRONT RANGE PAIN MEDICINE LLC |
| 1201 N Erie St, Lexington, NE 68850-1571 | 3083245651 | LEXINGTON REGIONAL HEALTH CENTER |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 66% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 54% | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PSE_1 | Patient-Specific Education | 29% | |
| MIPS_EC_131_overall | Pain Assessment and Follow-Up | 100% |
| Organization Legal Name | FRONT RANGE PAIN MEDICINE LLC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Debra M Dennis | Physician Assistant | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Jennifer L Harrison | Nurse Practitioner | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Sunny Park Henrion | Physician Assistant | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Michael Brien Brown | Anesthesiology | Front Range Pain Medicine LLC | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 |
| Samantha J Desenberg | Nurse Practitioner | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| George E Girardi | Anesthesiology | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Colin Michael Carpenter | Physical Medicine and Rehabilitation | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Street Address |
3744 S TIMBERLINE RD SUITE 102 |
| City | FORT COLLINS |
| State | CO |
| Zip | 80525-4334 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Debra M Dennis | Physician Assistant | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Jennifer L Harrison | Nurse Practitioner | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Sunny Park Henrion | Physician Assistant | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Maud V Monnet | Physical Therapy | Colorado Physical Therapy Specialists Pllc | 3744 S Timberline Rd, Suite 103, Fort Collins, CO 80525-4334 |
| Samantha J Desenberg | Nurse Practitioner | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| George E Girardi | Anesthesiology | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Martha M Watt | Occupational Therapy | Colorado Physical Therapy Specialists Pllc | 3744 S Timberline Rd, Suite 103, Fort Collins, CO 80525-4334 |
| Colin Michael Carpenter | Physical Medicine and Rehabilitation | Front Range Pain Medicine LLC | 3744 S Timberline Rd, Suite 102, Fort Collins, CO 80525-4334 |
| Susan M Dukart | Occupational Therapy | Colorado Physical Therapy Specialists Pllc | 3744 S Timberline Rd, Suite 103, Fort Collins, CO 80525-4334 |
| Brenda K Cummings | Occupational Therapy | Colorado Physical Therapy Specialists Pllc | 3744 S Timberline Rd, Suite 103, Fort Collins, CO 80525-4334 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Corrine M Layton | Occupational Therapy | Ensight Skills Center, Inc. | 1740 S College Ave, Fort Collins, CO 80525-1009 |
| Corey Byron Bernhardt | Optometry | Ensight Skills Center, Inc. | 1740 S College Ave, Fort Collins, CO 80525-1009 |
| Kursten K Von Koss | Occupational Therapy | Ensight Skills Center, Inc. | 1740 S College Ave, Fort Collins, CO 80525-1009 |
| Megan Baca | Optometry | Ensight Skills Center, Inc. | 1740 S College Ave, Fort Collins, CO 80525-1009 |
| Lisa Marie Faust | Occupational Therapy | Ensight Skills Center, Inc. | 1740 S College Ave, Fort Collins, CO 80525-1009 |
| David H Kisling | Optometry | Ensight Skills Center, Inc. | 1740 S College Ave, Fort Collins, CO 80525-1009 |
| Silvia Sorensen | Physical Therapy | 1325 E Prospect Rd, Fort Collins, CO 80525-1115 | |
| James Haas | Chiropractic | 1337 E Prospect Rd, Ft Collins, CO 80525-1115 | |
| Greg L Crawford | Chiropractic | 1337 E Prospect Rd, Fort Collins, CO 80525-1115 | |
| Steven L Kaufman | General Surgery | 1136 E Stuart St, Suite 4102, Fort Collins, CO 80525-1173 | |
| Find all physicians in zip 80525 | |||
| City | FORT COLLINS |
| Zip Code | 80525 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | FORT COLLINS + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Matthew D Pouliot.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.