NPIMap

Individual provider Active NPI

Elizabeth Tamaren

  • Surgical Physician Assistant
  • Boulder, CO
National Provider Identifier
1104594183
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0007125 Issued in CO
Practice address
4743 Arapahoe Ave Ste 202
Boulder, CO 80303-1128
Phone
(303) 938-5700
Fax
(303) 998-0007
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X PA.0007125 CO Primary

Addresses

Primary practice location

4743 Arapahoe Ave Ste 202
Boulder, CO 80303-1128

Mailing address

3310 Folsom St
Boulder, CO 80304-2404
Phone (314) 324-9881

Other practice location 1

4743 Arapahoe Ave Ste 100
Boulder, CO 80303-1123
Phone (303) 443-2123

Other identifiers 1

IdentifierTypeStateIssuer
9000200340MedicaidCO

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
I20211215001773 CO Practitioner - Physician Assistant 5890186423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

1755 48TH St
Suite 200
Boulder, CO 80301-2712
Phone (303) 415-7450

4743 Arapahoe Ave
Boulder, CO 80303-1128

4743 Arapahoe Ave
Suite 100
Boulder, CO 80303-1123
Phone (303) 443-2123

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7610

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Feb 5, 2022 Accepting new patients
Boulder Community Health CurrentSince Feb 5, 2022 Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

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

4743 Arapahoe Ave
Ste 202
Boulder, CO 80303
Phone (303) 938-5700

5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770

4743 Arapahoe Ave
Ste 100
Boulder, CO 80303
Phone (303) 415-4599

101 Erie Pkwy
Ste 201G
Erie, CO 80516
Phone (303) 415-4599

Organizations & group practices 5

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.

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": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1104594183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 FOLSOM ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042404",
            "telephone_number": "314-324-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4743 ARAPAHOE AVE STE 202",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031128",
            "telephone_number": "303-938-5700",
            "fax_number": "303-998-0007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4743 Arapahoe Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803031123",
            "country_code": "US",
            "telephone_number": "303-443-2123",
            "fax_number": "303-443-9497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAMAREN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0007125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000200340",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.