| Optimindhealth | |
|
4770 Baseline Rd Ste 200 Boulder CO 80303-2668 | |
| (720) 893-0842 | |
| Not Available |
| Full Name | Optimindhealth |
|---|---|
| Speciality | Clinic/Center |
| Location | 4770 Baseline Rd Ste 200, Boulder, Colorado |
| Authorized Official Name and Position | Joseph Yeretsian (PRESIDENT) |
| Authorized Official Contact | 6175071472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimindhealth 4770 Baseline Rd 2nd Floor Boulder CO 80303-2666 Ph: (720) 893-0842 | Optimindhealth 4770 Baseline Rd Ste 200 Boulder CO 80303-2668 Ph: (720) 893-0842 |
| NPI Number | 1942668165 |
|---|---|
| Provider Enumeration Date | 02/02/2016 |
| Last Update Date | 01/02/2020 |
| Certification Date | 01/02/2020 |
| Medicare PECOS PAC ID | 5597893313 |
|---|---|
| Medicare Enrollment ID | O20200318000673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942668165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | DR.0056212 (Colorado) | Primary |
| Provider Name | Joseph Yeretsian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003070210 PECOS PAC ID: 6002944824 Enrollment ID: I20200318000785 |
| Provider Name | Sarah Schumacher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336687060 PECOS PAC ID: 4183054331 Enrollment ID: I20200430002393 |
| Provider Name | Shanin Rae Vowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306434857 PECOS PAC ID: 0042628398 Enrollment ID: I20210426002495 |
| Provider Name | Christopher Jesus Mercado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457957532 PECOS PAC ID: 0749680585 Enrollment ID: I20210615003107 |
| Provider Name | Alex Joshua Betz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952905929 PECOS PAC ID: 0244634624 Enrollment ID: I20210806001380 |
| Provider Name | Jaimee Lyn Brielmaier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790429629 PECOS PAC ID: 2668848359 Enrollment ID: I20221020002727 |
| Provider Name | Alyssa Gosselin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427775980 PECOS PAC ID: 3375915945 Enrollment ID: I20230207003547 |
| Provider Name | Julie Marie Bass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083167019 PECOS PAC ID: 0941673388 Enrollment ID: I20230306000388 |
| Provider Name | Rebekah Bullock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285168344 PECOS PAC ID: 2567730153 Enrollment ID: I20230320000569 |
| Provider Name | Melody Bourret |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548926488 PECOS PAC ID: 1850753914 Enrollment ID: I20230822000901 |
| Provider Name | Kelsey Nicole Froom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487388435 PECOS PAC ID: 1557738804 Enrollment ID: I20231211001943 |
| Provider Name | Rebecca E Robitaille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154194199 PECOS PAC ID: 2365885191 Enrollment ID: I20240208003855 |
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