NPIMap

Individual provider Active NPI

Christopher Ahumada, PA

  • Physician Assistant
  • Boulder, CO
National Provider Identifier
1093429029
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0007748 Issued in CO
Practice address
2525 13TH St
Boulder, CO 80304-4104
Phone
(303) 650-4460
Fax
(720) 565-4132
NPI assigned
Jan 13, 2023
Last updated
Jan 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0007748 CO Primary

Addresses

Primary practice location

2525 13TH St
Boulder, CO 80304-4104

Mailing address

1735 S Public Rd # 203
Lafayette, CO 80026-7093
Phone (303) 665-3036

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
I20230204000291 CO Practitioner - Physician Assistant 1355713199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1735 S Public Rd
Lafayette, CO 80026-7093
Phone (303) 665-3036

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0007748COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Campesina Family Health Services CurrentSince Jan 23, 2023 Accepting new patients
Clinica Campesina Family Health Services CurrentSince Jan 23, 2023 Accepting new patients
Clinica Campesina Family Health Services Past Accepting new patients

Locations

2525 13th St
Boulder, CO 80304
Phone (303) 449-6050

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

1735 S Public Rd
#203
Lafayette, CO 80026

1735 S Public Rd
Ste 203
Lafayette, CO 80026

Interoperability endpoints

  • Direct secure messaging: christopher.ahumada.p4@direct.clinicafamilyhealth.nextgenshare.com

Organizations & group practices 4

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": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1093429029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 S PUBLIC RD # 203",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267093",
            "telephone_number": "303-665-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 13TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044104",
            "telephone_number": "303-650-4460",
            "fax_number": "720-565-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHUMADA",
        "first_name": "CHRISTOPHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0007748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.