MEDICARE: CAROLINE DEPRISCO M.D.

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	207V00000X	Obstetrics & Gynecology Physician	DR0052796	CO
2	390200000X	Student in an Organized Health Care Education/Training Program	TL-3594	CO

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	:	1528389368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE DEPRISCO M.D.

Provider Business Mailing Address
First Line	:	3012 CATHEDRAL PARK VW
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4723
Country	:	US
Telephone Number	:	303-601-1732
Fax Number	:

Provider Business Practice Location Address
First Line	:	3012 CATHEDRAL PARK VW
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4723
Country	:	US
Telephone Number	:	303-601-1732
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2010
Last Update Date	:	05/13/2026

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