Individual provider Active NPI

Hollis M Julson, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1104811470
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15497 Issued in NV
Practice address
888 S Rancho Dr
Las Vegas, NV 89106-3810
Phone
(702) 877-8600
Fax
(702) 258-6152
NPI assigned
Sep 13, 2005
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15497 NV Primary
Family Medicine Physician 207Q00000X DR.0049556 CO

Addresses

Primary practice location

888 S Rancho Dr
Las Vegas, NV 89106-3810

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 877-8600

Other practice location 1

17230 Jackson Creek Pkwy Ste 300
Monument, CO 80132-7306
Phone (719) 571-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000077 CO Practitioner - Family Practice 3274700182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2 S Cascade Ave
Suite 140
Colorado Springs, CO 80903-1624

2 S Cascade Ave
Suite 140
Colorado Springs, CO 80903-6104

9100 E Mineral Cir
Centennial, CO 80112-3401

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0049556COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Optumcare Colorado Medical Group LLC Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2023 Accepting new patients
Optumcare Colorado Medical Group LLC Family Medicine CurrentSince Sep 12, 2022 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Sep 12, 2022 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

17230 Jackson Creek Pkwy
Ste 300
Monument, CO 80132
Phone (713) 422-0808

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

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.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1104811470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-877-8600",
            "fax_number": "702-258-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S RANCHO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063810",
            "telephone_number": "702-877-8600",
            "fax_number": "702-258-6152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17230 Jackson Creek Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Monument",
            "state": "CO",
            "postal_code": "801327306",
            "country_code": "US",
            "telephone_number": "719-571-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JULSON",
        "first_name": "HOLLIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "15497",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0049556",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.