NPIMap

Individual provider Active NPI

Laura Elizabeth Bland, PA-C

  • Medical Physician Assistant
  • Broomfield, CO
National Provider Identifier
1013105105
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA3950 Issued in CO
Practice address
433 Summit Blvd Unit 201
Broomfield, CO 80021-8299
Phone
(303) 673-9090
Fax
(303) 673-9195
NPI assigned
Oct 15, 2007
Last updated
Apr 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3950 CO Primary

Addresses

Primary practice location

433 Summit Blvd Unit 201
Broomfield, CO 80021-8299

Mailing address

433 Summit Blvd Unit 201
Broomfield, CO 80021-8299
Phone (303) 673-9090

Other identifiers 1

IdentifierTypeStateIssuer
9000143508MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170315001601 CO Practitioner - Physician Assistant 1153407267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Baylor College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Practice Associates PCGroup PAC ID 7618943432, 2 clinicians

Practice addresses (Care Compare)

433 Summit Blvd
Broomfield, CO 80021-8299
Phone (303) 673-9090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3950COMDMedical Physician Assistant

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBHGDD/Endpoint/GBHGDD
  • Direct secure messaging: laura.bland.p13@direct.ipn.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 43

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 43

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1013105105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 SUMMIT BLVD UNIT 201",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218299",
            "telephone_number": "303-673-9090",
            "fax_number": "303-673-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SUMMIT BLVD UNIT 201",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218299",
            "telephone_number": "303-673-9090",
            "fax_number": "303-673-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAND",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA3950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000143508",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.