| Boulder Medical Center, P.c. | |
|
2750 Broadway St Boulder CO 80304-3573 | |
| (303) 440-3000 | |
| Not Available |
| Full Name | Boulder Medical Center, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2750 Broadway St, Boulder, Colorado |
| Authorized Official Name and Position | Casandra Richards (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 3034403076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulder Medical Center, P.c. 2750 Broadway St Boulder CO 80304-3573 Ph: (303) 440-3000 | Boulder Medical Center, P.c. 2750 Broadway St Boulder CO 80304-3573 Ph: (303) 440-3000 |
| NPI Number | 1306820923 |
|---|---|
| Provider Enumeration Date | 12/06/2005 |
| Last Update Date | 10/20/2023 |
| Medicare PECOS PAC ID | 4183536204 |
|---|---|
| Medicare Enrollment ID | O20031105000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306820923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Rosemary Greenslade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134245319 PECOS PAC ID: 5799688495 Enrollment ID: I20040129001133 |
| Provider Name | Ken O Kreidl |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1942284500 PECOS PAC ID: 9335130764 Enrollment ID: I20040524000245 |
| Provider Name | Jill L Siegfried |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013991611 PECOS PAC ID: 4486626876 Enrollment ID: I20040806000774 |
| Provider Name | David H Kruger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639142417 PECOS PAC ID: 6800851726 Enrollment ID: I20041119000687 |
| Provider Name | Ruth K Weinberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639305873 PECOS PAC ID: 8628023843 Enrollment ID: I20050321000375 |
| Provider Name | Christopher R Pohlman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063496669 PECOS PAC ID: 5991733321 Enrollment ID: I20050727001108 |
| Provider Name | Karen M Andrews |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1750365565 PECOS PAC ID: 4486683711 Enrollment ID: I20050808000485 |
| Provider Name | Cynthia Goacher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730124975 PECOS PAC ID: 0345250882 Enrollment ID: I20060428000201 |
| Provider Name | Connor W Graham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669421301 PECOS PAC ID: 8224040092 Enrollment ID: I20060616000078 |
| Provider Name | Jose M Delgado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275559049 PECOS PAC ID: 0446231260 Enrollment ID: I20070703000129 |
| Provider Name | Tara T Parks |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659417731 PECOS PAC ID: 0941300099 Enrollment ID: I20070703000245 |
| Provider Name | Erin Harper-sanchez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629293436 PECOS PAC ID: 4284735705 Enrollment ID: I20070726000812 |
| Provider Name | Karin R Knapp |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801063433 PECOS PAC ID: 1052476736 Enrollment ID: I20090212000233 |
| Provider Name | Long P Huynh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508059288 PECOS PAC ID: 8921164823 Enrollment ID: I20090302000101 |
| Provider Name | Stuart M Weisman |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1326022930 PECOS PAC ID: 9436216215 Enrollment ID: I20090323000255 |
| Provider Name | Laura K Erben |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265637607 PECOS PAC ID: 7315080447 Enrollment ID: I20100211000281 |
| Provider Name | Robert H Levine |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124003330 PECOS PAC ID: 5799810297 Enrollment ID: I20100323000632 |
| Provider Name | Maureen A Dickerson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801870563 PECOS PAC ID: 5799810107 Enrollment ID: I20100323000878 |
| Provider Name | Coco Dughi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356325013 PECOS PAC ID: 2365578747 Enrollment ID: I20100325000454 |
| Provider Name | Michael J Repine |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316921919 PECOS PAC ID: 8527194505 Enrollment ID: I20100329001042 |
| Provider Name | Hilary F Wallace |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437133048 PECOS PAC ID: 0941337786 Enrollment ID: I20100427000396 |
| Provider Name | Rebecca D Kierein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609850247 PECOS PAC ID: 0446387294 Enrollment ID: I20100427000475 |
| Provider Name | Donald L Mccormack |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1275518482 PECOS PAC ID: 7810024684 Enrollment ID: I20100427000701 |
| Provider Name | Randolph A Pinto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285619411 PECOS PAC ID: 1951438738 Enrollment ID: I20100427000761 |
| Provider Name | Cheryl L Cavanaugh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508840257 PECOS PAC ID: 7113054875 Enrollment ID: I20100428000887 |
| Provider Name | Karin N Susskind |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093799694 PECOS PAC ID: 8921135609 Enrollment ID: I20100429000186 |
| Provider Name | Jon S Rubright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679522551 PECOS PAC ID: 9638206253 Enrollment ID: I20100429000777 |
| Provider Name | Jennifer H Christensen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750365417 PECOS PAC ID: 3678601127 Enrollment ID: I20100504000868 |
| Provider Name | Kimberly Dana Lerner |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1225254782 PECOS PAC ID: 7315079357 Enrollment ID: I20100709000700 |
| Provider Name | Patricia A Zishka |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1164406781 PECOS PAC ID: 1850458944 Enrollment ID: I20100728000421 |
| Provider Name | Jarod A Conley |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1871676148 PECOS PAC ID: 1850583204 Enrollment ID: I20101004001516 |
| Provider Name | David Wayne Link |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558389221 PECOS PAC ID: 2062609852 Enrollment ID: I20101206000780 |
| Provider Name | Heather M Bright-hoffmeyer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336116946 PECOS PAC ID: 9537339528 Enrollment ID: I20110830000763 |
| Provider Name | Melissa Greenfield Serlen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730164401 PECOS PAC ID: 3779755756 Enrollment ID: I20111017000761 |
| Provider Name | Brett A Schultz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922217884 PECOS PAC ID: 2163569476 Enrollment ID: I20111019000696 |
| Provider Name | Lori Lieberman Maran |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1740373687 PECOS PAC ID: 4486751963 Enrollment ID: I20111108000423 |
| Provider Name | Kathryn M Hoch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639268642 PECOS PAC ID: 1456303197 Enrollment ID: I20120210000225 |
| Provider Name | Robyn Js Nordstrom Lane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902028079 PECOS PAC ID: 1850481565 Enrollment ID: I20131120000469 |
| Provider Name | Andrea M Mertz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255651188 PECOS PAC ID: 1052549557 Enrollment ID: I20140108000318 |
| Provider Name | Christine H Abair |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023212610 PECOS PAC ID: 3971652017 Enrollment ID: I20140122001288 |
| Provider Name | Mark A Birmingham |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396913117 PECOS PAC ID: 0143371971 Enrollment ID: I20140128000506 |
| Provider Name | Lauren Brave |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285603696 PECOS PAC ID: 8426085390 Enrollment ID: I20140410000949 |
| Provider Name | Mark A Hunter |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1245464692 PECOS PAC ID: 7911125885 Enrollment ID: I20140908000187 |
| Provider Name | Angela C Paddack |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871767954 PECOS PAC ID: 3375786999 Enrollment ID: I20141010001777 |
| Provider Name | Madeline V Hoglund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962802488 PECOS PAC ID: 7810118767 Enrollment ID: I20141020000322 |
| Provider Name | Jill S Murphey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962403782 PECOS PAC ID: 6800999319 Enrollment ID: I20150212000249 |
| Provider Name | Emma E K Mccarty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275537078 PECOS PAC ID: 5496758732 Enrollment ID: I20150612002262 |
| Provider Name | Evan Enloe Minard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912955329 PECOS PAC ID: 7416902366 Enrollment ID: I20151214002265 |
| Provider Name | Rebecca M Juliar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760774897 PECOS PAC ID: 0749412849 Enrollment ID: I20160121002218 |
| Provider Name | Jennifer B Grodberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114067097 PECOS PAC ID: 7315925815 Enrollment ID: I20170919000963 |
| Provider Name | Dominik K Rog |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679863112 PECOS PAC ID: 8224302575 Enrollment ID: I20170925003422 |
| Provider Name | Shawn Denham |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1336581693 PECOS PAC ID: 8325303894 Enrollment ID: I20180604002314 |
| Provider Name | Katherine L Mccormack |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1194085183 PECOS PAC ID: 0244532034 Enrollment ID: I20180711002654 |
| Provider Name | Katherine Chesney Kennedy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376743856 PECOS PAC ID: 1153519236 Enrollment ID: I20180725002240 |
| Provider Name | Helen Y Rho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710305073 PECOS PAC ID: 3375843402 Enrollment ID: I20180911001820 |
| Provider Name | Stephen B Siegel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902860091 PECOS PAC ID: 3577579887 Enrollment ID: I20181113000222 |
| Provider Name | Kelly Korte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396227864 PECOS PAC ID: 2860731924 Enrollment ID: I20190307000693 |
| Provider Name | James Gottlieb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811213838 PECOS PAC ID: 7012157019 Enrollment ID: I20190612001826 |
| Provider Name | Lindsay Nicole Boyers |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1376938407 PECOS PAC ID: 4981933272 Enrollment ID: I20190911003789 |
| Provider Name | Elise Marie Itano |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1225449754 PECOS PAC ID: 2961700398 Enrollment ID: I20190919001637 |
| Provider Name | Jenna Marie Peart |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1912391285 PECOS PAC ID: 6608104740 Enrollment ID: I20200527001421 |
| Provider Name | Gillian Claire Johnston Ditton |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1891174801 PECOS PAC ID: 7719276237 Enrollment ID: I20200727000326 |
| Provider Name | Harold Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801860101 PECOS PAC ID: 6901941897 Enrollment ID: I20200804000405 |
| Provider Name | Timothy Jaeger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124559398 PECOS PAC ID: 5890064422 Enrollment ID: I20201002000206 |
| Provider Name | Krista Toomre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427007830 PECOS PAC ID: 4688700024 Enrollment ID: I20201020003595 |
| Provider Name | Christie Blanton |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780818286 PECOS PAC ID: 0648588806 Enrollment ID: I20210401000167 |
| Provider Name | Stacie Teresa Mccally |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679183172 PECOS PAC ID: 9032527486 Enrollment ID: I20210423000448 |
| Provider Name | Tobey Schultz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679984405 PECOS PAC ID: 7214251628 Enrollment ID: I20210826002259 |
| Provider Name | Emily A Reznicek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619474822 PECOS PAC ID: 3375899412 Enrollment ID: I20210913000972 |
| Provider Name | Allen Ruan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689100711 PECOS PAC ID: 5092136341 Enrollment ID: I20211021001613 |
| Provider Name | Alexandra Marie Parshall |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1093472680 PECOS PAC ID: 7113317728 Enrollment ID: I20211214000059 |
| Provider Name | Felicia Longenecker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710243217 PECOS PAC ID: 9638482573 Enrollment ID: I20220207002617 |
| Provider Name | Sidarth Dasari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497286421 PECOS PAC ID: 7214208396 Enrollment ID: I20220921001805 |
| Provider Name | William Logan Gladney |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548722820 PECOS PAC ID: 1456736784 Enrollment ID: I20220922000436 |
| Provider Name | Brian Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366977894 PECOS PAC ID: 3577833599 Enrollment ID: I20221010002701 |
| Provider Name | Trent Jarvis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881259091 PECOS PAC ID: 9739415019 Enrollment ID: I20221018002088 |
| Provider Name | Jennifer Beck |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184887069 PECOS PAC ID: 3476868605 Enrollment ID: I20230215000989 |
| Provider Name | Neha Vaitha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154642130 PECOS PAC ID: 5890935878 Enrollment ID: I20230403000318 |
| Provider Name | Fabiana Monte Alegre Olmos Fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588288013 PECOS PAC ID: 0042638074 Enrollment ID: I20230719000542 |
| Provider Name | Jarrell Rayner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902434814 PECOS PAC ID: 9234534264 Enrollment ID: I20230719003103 |
| Provider Name | Neal Trulock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790289270 PECOS PAC ID: 4183006992 Enrollment ID: I20230814002456 |
| Provider Name | Elizabeth Alaimo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427404607 PECOS PAC ID: 8628329117 Enrollment ID: I20231127000405 |
Pearl Podiatry Health Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2575 Pearl St, Suite #240, Boulder, CO 80302 Phone: 303-442-2910 Fax: 303-442-2931 | |
Community Medical Assoc Of Bch Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5495 Arapahoe Ave Ste 100, Boulder, CO 80303 Phone: 303-415-4250 Fax: 303-440-9629 | |
High Altitude Spine And Sport Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2995 Baseline Rd, #101, Boulder, CO 80303 Phone: 303-829-1040 Fax: 303-440-0905 | |
Boulder Center For Age Management Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1650 38th St Ste 207w, Boulder, CO 80301 Phone: 720-381-3318 Fax: 720-496-1780 | |
University Of Colorado Hospital Authority Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5495 Arapahoe Ave, Boulder, CO 80303 Phone: 303-544-3900 | |
Kaiser Permanente Baseline Medical Offices Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 580 Mohawk Dr, Boulder, CO 80303 Phone: 303-338-4545 | |
Wardenburg Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 Wardenburg Drive University Of Colorado, Boulder, CO 80309 Phone: 303-492-5101 Fax: 303-492-1747 |