Boulder Center for Age Management Medicine PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BOULDER CENTER FOR AGE MANAGEMENT MEDICINE PC

Practice address

1650 38TH St Ste 207W
Boulder, CO 80301-2637

Phone

(720) 381-3318

Fax

(720) 496-1780

NPI assigned

Jun 2, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Todd DorfmanNPI 1629053616

Title

Founder and Ceo

Phone

(720) 381-3318

Specialties & licenses 1

Addresses

Other names 1

• Cedalion Health Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd Alan Dorfman, MD

  • Emergency Medicine Physician
  • Boulder, CO
  • NPI 1629053616

  General Practice

  NPD Authorized official
• Adam Benjamin Katz, MD

  • Student in an Organized Health Care Education/Training Program
  • Boulder, CO
  • NPI 1578343851
  NPD

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1023701141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 38TH ST STE 207W",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012637",
            "telephone_number": "720-381-3318",
            "fax_number": "720-496-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 38TH ST STE 207W",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012637",
            "telephone_number": "720-381-3318",
            "fax_number": "720-496-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER CENTER FOR AGE MANAGEMENT MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "DORFMAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "FOUNDER AND CEO",
        "authorized_official_telephone_number": "720-381-3318",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedalion Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• General Practice Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.