Individual provider Active NPI

Gustavo Luis Isuani, M.D.

  • Diagnostic Radiology Physician
  • Boulder, CO
National Provider Identifier
1073588778
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
41718 Issued in CO
Practice address
4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone
(303) 465-0401
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 41718 CO Primary
Diagnostic Radiology Physician 2085R0202X D0050174 MD
Neuroradiology Physician 2085N0700X D0050174 MD

Addresses

Primary practice location

4747 Arapahoe Ave
Boulder, CO 80303-1131

Mailing address

42 Garden Ctr
Broomfield, CO 80020-1730
Phone (303) 465-0401

Other practice location 1

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1301

Other practice location 2

1100 Balsam Ave
Boulder, CO 80304-3404
Phone (303) 465-0401 ext. 102

Other practice location 3

22 S Greene St Rm S2A19
Baltimore, MD 21201-1544
Phone (410) 328-3477

Other identifiers 1

IdentifierTypeStateIssuer
66127009MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO, MD, DC4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20050616000461 TX Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 1052355450 Reassigns benefits to 2 organizations
I20131101001323 CO Practitioner - Diagnostic Radiology 1052355450 Reassigns benefits to 3 organizations
I20251122000231 MD Practitioner - Diagnostic Radiology 1052355450 Reassigns benefits to 3 organizations
I20251122000350 DC Practitioner - Diagnostic Radiology 1052355450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Baylor College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Ultrasound IncGroup PAC ID 0547254823, 9 clinicians
Memorial MRI and Diagnostic LLCGroup PAC ID 6507859568, 77 clinicians
University Imaging Center, LLCGroup PAC ID 2769378686, 56 clinicians
Boulder Radiologists Inc P CGroup PAC ID 4183510274, 13 clinicians

Practice addresses (Care Compare)

122 W Castellano Dr
El Paso, TX 79912-6170
Phone (915) 577-0100

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5700

419 W Redwood St
Baltimore, MD 21201-1734
Phone (410) 328-3225

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 465-0401

5 N la Plata CT
Suite 104
La Plata, MD 20646-5207
Phone (301) 539-0345

6509 Legend Ridge TRL
Niwot, CO 80503-7188
Phone (410) 328-3477

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41718COMDDiagnostic Radiology Physician
D0050174MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Ultrasound Inc. CurrentSince Dec 3, 2020 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Neuroradiology CurrentSince Nov 15, 2025 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Neuroradiology CurrentSince Nov 15, 2025 Accepting new patients
Boulder Radiologists Inc P C Diagnostic Radiology CurrentSince Aug 1, 2003 Accepting new patients
Memorial MRI and Diagnostic LLC Diagnostic Radiology CurrentSince Aug 20, 2025 Accepting new patients
University Imaging Center, LLC Neuroradiology CurrentSince Nov 15, 2025 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Neuroradiology CurrentSince Nov 15, 2025 Accepting new patients
University Imaging Center, LLC Neuroradiology CurrentSince Nov 15, 2025 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Neuroradiology CurrentSince Nov 15, 2025 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Neuroradiology PastSince Jan 26, 2025 Accepting new patients
Insight Health Corporation Diagnostic Radiology Past Accepting new patients
Medical Imaging of Dallas, LLP PastSince Jun 30, 2004 Accepting new patients
Bouldercentre for Orthopedics PC Past Accepting new patients
Columbus Radiology Corp Diagnostic Radiology Past Accepting new patients

Locations (25 of 28)

2750 Broadway St
Boulder, CO 80304
Phone (303) 440-3000

6685 Gunpark Dr
Ste 102
Boulder, CO 80301
Phone (303) 415-5199

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

4740 Pearl Pkwy
Ste 110
Boulder, CO 80301

2880 Folsom St
Ste 100
Boulder, CO 80304
Phone (303) 247-9696

1100 Balsam Ave
Boulder, CO 80304
Phone (303) 415-7000

36 Garden Ctr
Broomfield, CO 80020
Phone (303) 465-0401

42 Garden Ctr
Broomfield, CO 80020

101 Erie Pkwy
Erie, CO 80516
Phone (303) 415-5170

1000 W South Boulder Rd
Ste 105
Lafayette, CO 80026
Phone (303) 604-5031

22 S Greene St
Rm S2A19
Baltimore, MD 21201
Phone (410) 328-1565

22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

5 N La Plata Ct
Ste 104
La Plata, MD 20646
Phone (301) 539-0345

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

6491 Southwest Blvd
Benbrook, TX 76132
Phone (214) 341-8770

3502 Spid Dr
Corpus Christi, TX 78415
Phone (361) 854-4400

122 W Castellano Dr
El Paso, TX 79912
Phone 91557701002500

7812 Gateway Blvd E
Ste 120
El Paso, TX 79915
Phone (502) 533-3854

7812 Gateway Blvd E
El Paso, TX 79915
Phone (936) 444-4884

3080 Joe Battle Blvd
Ste B
El Paso, TX 79938
Phone (915) 313-7325

1727 N Lee Trevino Dr
El Paso, TX 79936
Phone (915) 225-0366

3080 Joe Battle Blvd
El Paso, TX 79938
Phone (915) 298-3607

13650 Eastlake Blvd
Ste A102
Horizon City, TX 79928

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 15

Hospital & facility affiliations 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1073588778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 GARDEN CTR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201730",
            "telephone_number": "303-465-0401",
            "fax_number": "303-438-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 ARAPAHOE AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031131",
            "telephone_number": "303-465-0401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Minnesota Dr Ste 800",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554357915",
            "country_code": "US",
            "telephone_number": "952-595-1301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Balsam Ave",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043404",
            "country_code": "US",
            "telephone_number": "303-465-0401 x102",
            "fax_number": "303-438-1351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 S Greene St Rm S2A19",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-3477",
            "fax_number": "410-328-1565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISUANI",
        "first_name": "GUSTAVO",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "41718",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0050174",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MD",
            "license": "D0050174",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66127009",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.