NPIMap

Individual provider Active NPI

Michael Corey McCarty, D.O.

  • Family Medicine Physician
  • Boulder, CO
National Provider Identifier
1073578894
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42850 Issued in CO
Practice address
6685 Gunpark Dr
Ste. 110
Boulder, CO 80301-3388
Phone
(303) 415-7599
Fax
(303) 530-5474
NPI assigned
Apr 18, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 42850 CO Primary

Addresses

Primary practice location

6685 Gunpark Dr
Ste. 110
Boulder, CO 80301-3388

Mailing address

5450 Western Ave
Suite B
Boulder, CO 80301-2709
Phone (303) 415-7599

Other identifiers 1

IdentifierTypeStateIssuer
11305046MedicaidCO

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
I20050415000062 CO Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 3072550508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

1000 W S Boulder Rd
Suite 110
Lafayette, CO 80026-2753
Phone (303) 415-4355

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42850COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Aug 20, 2012 Accepting new patients
Boulder Community Health CurrentSince Aug 20, 2012 Accepting new patients
Boulder Community Health Current Accepting new patients
Thornton Medical Center, P.C. Family Medicine Past Accepting new patients
Boulder Community Health Past Accepting new patients
Intermountain Front Range, Inc. Past Accepting new patients
Providence Healthcare Associates PC Family Medicine PastSince Jul 23, 2007 Accepting new patients

Locations

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

5450 Western Ave
Ste B
Boulder, CO 80301

6685 Gunpark Dr
Ste 110
Boulder, CO 80301
Phone (303) 415-7599

1000 W South Boulder Rd
Ste 110
Lafayette, CO 80026
Phone (303) 415-4355

Organizations & group practices 7

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073578894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "address_2": "SUITE B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-7599",
            "fax_number": "303-530-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6685 GUNPARK DR",
            "address_2": "STE. 110",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013388",
            "telephone_number": "303-415-7599",
            "fax_number": "303-530-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTY",
        "first_name": "MICHAEL",
        "middle_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "42850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11305046",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.