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21ST MEDGRP-PETERSON
NPI 1942286224
Clinic/Center - Military/U.S. Coast Guard Outpatient in Peterson Afb, CO

Active since December 19, 2005
559 VINCENT ST, PETERSON AFB, CO 80914(719) 556-1250 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 17, 2025, Jun 12, 2025 (2 updates tracked since 2025).

About 21st Medgrp-peterson NPPES

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

21ST MEDGRP-PETERSON (NPI 1942286224) is a healthcare organization registered as a military/u.s. coast guard outpatient in Peterson Afb, Colorado and active in the NPI registry since December 2005. The organization lists Jen Lewandowski, Dha Ubo, as its authorized official.

NPPES Registry Identity

NPI1942286224
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business Name21ST MEDGRP-PETERSON
Location Address559 VINCENT STPeterson Afb, CO 80914-1541
Mailing Address559 Vincent StPeterson Afb, CO 80914-1541 · (719) 556-1250
Phone(719) 556-1250
Organization SubpartYes
Authorized OfficialJen LewandowskiDha Ubo · (703) 817-4030
Enumeration DateDecember 19, 2005
Last NPPES UpdateJune 17, 20252 updates tracked since enumeration
NPPES CertifiedJune 17, 2025
✔ NPI 1942286224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities
Taxonomy Code261QM1100X
Definition
The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
Also ListedClinic/Center · Military and U.S. Coast Guard Ambulatory ProcedureTaxonomy 261QM1101X
Also ListedMilitary/U.S. Coast Guard PharmacyTaxonomy 332000000X
559 VINCENT ST, Peterson Afb, CO 80914
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Other Names 1

Other NamePeterson Afb Mtf

Other Identifiers 2

Other1548369259CO · Nppes
Other06-16788CO · Ncpdp

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRYSTIN HUST DPT
Physical Therapist
559 VINCENT ST
PETERSON AFB, CO 80914
El Paso County (719) 524-2273
JAMES NEAL SUTHERLAND DDS
Dentist
559 VINCENT ST
PETERSON AFB, CO 80914
El Paso County (719) 556-1060
WAYNE ERWIN GRABOW DENTIST DDS
Dentist
559 VINCENT ST, 21 DS/SGGD-DENTAL CLINIC
PETERSON AFB, CO 80914
El Paso County (719) 556-1333
MICHELLE MONTGOMERY WHNP
Nurse Practitioner (Women's Health)
559 VINCENT ST, FAMILY PRACTICE CLINIC
PETERSON AFB, CO 80914
El Paso County (719) 556-1080
MEREDITH L FAAS LCSW
Social Worker (Clinical)
559 VINCENT ST
COLORADO SPRINGS, CO 80914
El Paso County (719) 357-8957
MR. RYAN S OGILVY MSW, LCSW
Social Worker (Clinical)
559 VINCENT ST, ATTN: 21MDOS/SGOW- MENTAL HEALTH
PETERSON AFB, CO 80914
El Paso County (719) 556-7804
ALICIA TERESA ROZYCKI PH.D.
Psychologist (Counseling)
559 VINCENT ST, ATTN: 21 MDS - SGOF
PETERSON AFB, CO 80914
El Paso County (719) 567-4489
DR. LOUIS A PAGANO JR. PH.D.
Psychologist (Counseling)
559 VINCENT ST, ATTN: 21 MDS/SGOW-MENTAL HEALTH
PETERSON AFB, CO 80914
El Paso County (719) 526-8873

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 21st Medgrp-Peterson's NPI number?

The NPI number for 21st Medgrp-Peterson is 1942286224. It was assigned to this organization in the NPPES registry on December 19, 2005. The provider is also known as Peterson AFB MTF.

Where is 21st Medgrp-Peterson located?

21st Medgrp-Peterson is located at 559 Vincent St, Peterson Afb, CO 80914. The listed phone number is (719) 556-1250.

What is 21st Medgrp-Peterson's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

When was this NPI record last updated?

The NPPES record for 21st Medgrp-Peterson was last updated on June 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.