Active NPI
Tess Eklund
- Surgical Assistant
- Boulder, CO
National Provider Identifier
1114284346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 1530
- Practice address
- 3000 Center Green Dr Ste 150
Boulder, CO 80301-2364 - Phone
- (303) 449-8807
- NPI assigned
- Apr 12, 2012
- 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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 1530 | CO | Primary |
Addresses
Primary practice location
3000 Center Green Dr Ste 150
Boulder, CO 80301-2364
Mailing address
10255 Dover St Apt 432
Westminster, CO 80021-3986
Phone (970) 376-1729
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1530 | Other | CO | ACTIVE SURGICAL ASSISTANT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1530 | CO | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Institute for Sports Medicine, P.C. | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/10724/brand/1/csg/1/fhir/r4
Organizations & group practices 1
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.
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Boulder, CO
- NPI 1235308982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1114284346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10255 DOVER ST APT 432",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "800213986",
"telephone_number": "970-376-1729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 CENTER GREEN DR STE 150",
"city": "BOULDER",
"state": "CO",
"postal_code": "803012364",
"telephone_number": "303-449-8807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EKLUND",
"first_name": "TESS",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-12",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "CO",
"license": "1530",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACTIVE SURGICAL ASSISTANT",
"identifier": "1530",
"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 Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.