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DR. MIKAELA ROSE FENN MD
NPI 1083292817
Family Medicine in Pueblo, CO

Active since April 01, 2021PECOS EnrolledAccepts Medicare Assignment
1307 E. 7TH AVENUE, PUEBLO, CO 81001(719) 543-8711(719) 543-0171 Get Directions Write a Review

NPPES record last updated: July 23, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 23, 2024, Apr 1, 2021 (2 updates tracked since 2021).

About Dr. Mikaela Rose Fenn Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MIKAELA ROSE FENN MD (NPI 1083292817) is an individual family medicine provider in Pueblo, Colorado, licensed in Colorado (0073570) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of University Of Pittsburgh School Of Medicine (2021).

NPPES Registry Identity

NPI1083292817
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MIKAELA ROSE FENNCredential: MD
Location Address1307 E. 7TH AVENUEPueblo, CO 81001
Mailing Address110 E Routt AvePueblo, CO 81004-2117 · (719) 543-8711 · Fax (719) 543-0171
Phone(719) 543-8711
Fax(719) 543-0171
Sole ProprietorNo
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 2021
Enumeration DateApril 1, 2021
Last NPPES UpdateJuly 23, 20242 updates tracked since enumeration
NPPES CertifiedJuly 16, 2024
✔ NPI 1083292817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CO · 0073570
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1307 E. 7TH AVENUE, Pueblo, CO 81001
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mikaela Rose Fenn Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335549567
PECOS Enrollment IDI20241213001368
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mikaela Fenn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pueblo Community Health Center Inc
2.2 mi
Federally Qualified Health Center (FQHC)
300 COLORADO AVE
Pueblo, CO 81004
  • Reassigned Medicare billing, Colorado enrollment
  • 137 clinicians in this Medicare group
NPI 1770529950 (719) 543-8711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 81001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mikaela Fenn's NPI number?

The NPI number for Mikaela Fenn is 1083292817. It was assigned to this individual provider in the NPPES registry on April 1, 2021.

Where is Mikaela Fenn located?

Mikaela Fenn practices at 1307 E. 7th Avenue, Pueblo, CO 81001. The listed phone number is (719) 543-8711.

What is Mikaela Fenn's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mikaela Fenn enrolled in Medicare?

Yes. Mikaela Fenn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Mikaela Fenn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mikaela Fenn reassigns Medicare benefits to Pueblo Community Health Center Inc (Pueblo, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mikaela Fenn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mikaela Fenn was last updated on July 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.