Active NPI
Jennifer B Grodberg, MD
- Internal Medicine Physician
- Boulder, CO
National Provider Identifier
1114067097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DR.0058293
- Practice address
- 2750 Broadway St
Boulder, CO 80304-3573 - Phone
- (303) 440-3082
- Fax
- (303) 440-3281
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | DR.0058293 | CO | Primary |
Addresses
Primary practice location
2750 Broadway St
Boulder, CO 80304-3573
Mailing address
2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3000
Hospital & facility affiliations
- Boulder Community Health
- University of Colorado Hospital Authority
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Medical Center, P.C. | Current | Accepting new patients | |
| Boulder Medical Center, P.C. | Current | Accepting new patients | |
| Boulder Medical Center, P.C. | Current | Accepting new patients | |
| Medical Center Pharmacy Inc | Past | Accepting new patients |
Locations
2750 Broadway St
Boulder, CO 80304
Phone (303) 440-3000
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1306820923
-
- Urgent Care Clinic/Center
- Boulder, CO
- NPI 1114886587
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1174156939
-
- Community/Retail Pharmacy
- Salt Lake City, UT
- NPI 1861495160
Hospital & facility affiliations 61
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516752000000",
"number": "1114067097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2750 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043573",
"telephone_number": "303-440-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043573",
"telephone_number": "303-440-3082",
"fax_number": "303-440-3281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRODBERG",
"first_name": "JENNIFER",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2018-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "DR.0058293",
"primary": true
}
],
"identifiers": [],
"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 Jan 24, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.