Active NPI
Gila Ethel Ackerman, M.D.
- Psychiatry Physician
- Boulder, CO
National Provider Identifier
1093884405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 41993
- Practice address
- 2727 Pine Street
Boulder, CO 80302 - Phone
- (720) 295-2456
- Fax
- (303) 459-6585
- NPI assigned
- Nov 7, 2006
- Last updated
- Dec 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 41993 | CO | |
| Psychiatry Physician | 2084P0800X | 41993 | CO | Primary |
Addresses
Primary practice location
2727 Pine Street
Boulder, CO 80302
Mailing address
2727 Pine Street
Boulder, CO 80302
Phone (720) 295-2456
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41993 | Other | CO | STATE LICENSE |
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 Nov 10, 2016 through Nov 10, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41993 | CO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1093884405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2727 PINE STREET",
"city": "BOULDER",
"state": "CO",
"postal_code": "80302",
"telephone_number": "720-295-2456",
"fax_number": "303-459-6588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2727 PINE STREET",
"city": "BOULDER",
"state": "CO",
"postal_code": "80302",
"telephone_number": "720-295-2456",
"fax_number": "303-459-6585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERMAN",
"first_name": "GILA",
"middle_name": "ETHEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "41993",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CO",
"license": "41993",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "41993",
"state": "CO"
}
],
"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 Dec 1, 2021; 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.