MEDICARE: COLORADO SPRINGS ORTHOPAEDIC GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		CO
2	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417957275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO SPRINGS ORTHOPAEDIC GROUP

Provider Business Mailing Address
First Line	:	4110 BRIARGATE PKWY STE 300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7837
Country	:	US
Telephone Number	:	719-632-7669
Fax Number	:	719-867-7322

Provider Business Practice Location Address
First Line	:	1259 LAKE PLAZA DR STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3542
Country	:	US
Telephone Number	:	719-867-7335
Fax Number	:	719-867-7378

Authorized Official
Title or Position	:	COO
Name	:	MS. AUTUMN WULF
Credential	:
Telephone Number	:	719-632-7669

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	09/22/2025

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