NPIMap

Individual provider Active NPI

Peter Boulos, M.D.

  • Interventional Cardiology Physician
  • Lafayette, CO
National Provider Identifier
1013375724
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
DR.0064228 Issued in CO
Practice address
200 Exempla Cir Ste 310
Lafayette, CO 80026-3370
Phone
(303) 689-6420
NPI assigned
Feb 9, 2016
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X DR.0064228 CO Primary
Cardiovascular Disease Physician 207RC0000X DR.0064228 CO

Addresses

Primary practice location

200 Exempla Cir Ste 310
Lafayette, CO 80026-3370

Mailing address

500 Eldorado Blvd Ste 4300
Broomfield, CO 80021-3564

Other practice location 1

1610 Prairie Center Pkwy Ste 2330
Brighton, CO 80601-4003
Phone (303) 272-0500

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
I20220211000156 CO Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional CardiologyPractitioner - Hospitalist 8527353325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Interventional Cardiology
Education
University of Colorado School of Medicine, Denver, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platte Valley Medical Group LLCGroup PAC ID 5890054100, 120 clinicians

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

12905 W 40TH Ave
Wheat Ridge, CO 80401-2793

1600 Prairie Ctr Pkwy
Brighton, CO 80601-4006
Phone (303) 498-1600

1610 Prairie Ctr Pkwy
Brighton, CO 80601-4003

1818 N Ogden St
Suite 400
Denver, CO 80218-1280
Phone (303) 318-2460

300 Exempla Cir
310 Imh Heart and Vascular Institute Lafayatt
Lafayette, CO 80026-3394
Phone (303) 272-0500

300 Exempla Cir
Suite 360 Im Heart and Vascular 360 Lafayet
Lafayette, CO 80026-3395
Phone (303) 272-0500

4859 Yampa St
Denver, CO 80249-7760
Phone (303) 498-1885

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Cardiovascular Disease Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Sep 1, 2025 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Sep 1, 2025 Accepting new patients
Platte Valley Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients
Platte Valley Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1818 N Ogden St
Ste 400
Denver, CO 80218
Phone (303) 318-2440

4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885

12905 W 40th Ave
Ste 305
Golden, CO 80401
Phone (303) 265-5730

200 Exempla Cir
Ste 310
Lafayette, CO 80026
Phone (303) 689-6420

300 Exempla Cir
Ste 310
Lafayette, CO 80026
Phone (303) 272-0500

Organizations & group practices 5

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 12

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

NPI Registry JSON

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1013375724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ELDORADO BLVD STE 4300",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EXEMPLA CIR STE 310",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-689-6420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 Prairie Center Pkwy Ste 2330",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "CO",
            "postal_code": "806014003",
            "country_code": "US",
            "telephone_number": "303-272-0500",
            "fax_number": "303-654-9895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-09",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CO",
            "license": "DR.0064228",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "DR.0064228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.