Individual provider Active NPI

Andrew James McBride, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Boulder, CO
National Provider Identifier
1053723023
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
DR.0058941 Issued in CO
Practice address
1755 48TH St Ste 200
Boulder, CO 80301
Phone
(303) 415-7450
Fax
(303) 494-5265
NPI assigned
May 27, 2014
Last updated
May 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0058941 CO
Sports Medicine (Family Medicine) Physician 207QS0010X DR.0058941 CO Primary

Addresses

Primary practice location

1755 48TH St Ste 200
Boulder, CO 80301

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 415-7450

Other practice location 1

955 lawrence st
denver, CO 80204
Phone (303) 556-2525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180703000182 CO Practitioner - Family PracticePractitioner - Sports Medicine 3375834344 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0058941COMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated Sports Medicine CurrentSince Jun 1, 2022 Accepting new patients
University Physicians Incorporated CurrentSince Jun 1, 2022 Accepting new patients
University Physicians Incorporated Family Medicine Current Accepting new patients
Boulder Community Health Past Accepting new patients
Colorado State University Past Accepting new patients
Metropolitan State University of Denver PastSince Aug 14, 2022 Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1053723023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-7450",
            "fax_number": "303-494-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 48TH ST STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80301",
            "telephone_number": "303-415-7450",
            "fax_number": "303-494-5265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 lawrence st",
            "address_purpose": "LOCATION",
            "city": "denver",
            "state": "CO",
            "postal_code": "80204",
            "country_code": "US",
            "telephone_number": "303-556-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2022-05-11",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0058941",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CO",
            "license": "DR.0058941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.