Active NPI
Mark G. Leifeste, M.D.
- Specialist
- Boulder, CO
National Provider Identifier
1033156427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 23486
- Practice address
- 4770 Baseline Rd
Suite #300
Boulder, CO 80303-2666 - Phone
- (303) 449-6577
- Fax
- (303) 447-1880
- NPI assigned
- Jun 2, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 23486 | CO | Primary |
Addresses
Primary practice location
4770 Baseline Rd
Suite #300
Boulder, CO 80303-2666
Mailing address
PO Box 2086
Fort Collins, CO 80522-2086
Phone (303) 444-3443
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 8, 2016 through Apr 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23486 | CO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1033156427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2086",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805222086",
"telephone_number": "303-444-3443",
"fax_number": "970-221-3730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4770 BASELINE RD",
"address_2": "SUITE #300",
"city": "BOULDER",
"state": "CO",
"postal_code": "803032666",
"telephone_number": "303-449-6577",
"fax_number": "303-447-1880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIFESTE",
"first_name": "MARK",
"middle_name": "G.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "23486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.