Individual provider Active NPI

Peter S Kaye, M.D., F.A.C.G.

  • Gastroenterology Physician
  • Boulder, CO
National Provider Identifier
1114946639
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
34974 Issued in CO
Practice address
1755 48TH St
Suite 100
Boulder, CO 80301-2711
Phone
(303) 604-5000
Fax
(720) 890-0364
NPI assigned
Jul 18, 2006
Last updated
Mar 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 34974 CO Primary

Addresses

Primary practice location

1755 48TH St
Suite 100
Boulder, CO 80301-2711

Mailing address

382 S Arthur Ave
Louisville, CO 80027-3094
Phone (303) 604-5000

Other identifiers 3

IdentifierTypeStateIssuer
KAA1348OtherCOBCBS
01349745MedicaidCO
100007622OtherCORAILROAD MEDICARE

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
I20110208000742 CO Practitioner - Gastroenterology 7517856891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34974COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Valley Gastroenterology Inc. Gastroenterology CurrentSince Jan 1, 1996 Accepting new patients
Boulder Valley Gastroenterology Inc. Gastroenterology CurrentSince Jan 1, 1996 Accepting new patients
Denver West Endoscopy Center, LLC PastSince Aug 15, 2012 Accepting new patients
St. Vrain Endoscopy Center LLC PastSince Mar 13, 2004 Accepting new patients

Locations

1755 48th St
Ste 100
Boulder, CO 80301
Phone (720) 932-7714

1000 W South Boulder Rd
Ste 200
Lafayette, CO 80026
Phone (720) 932-7719

1551 Professional Ln
Unit 290
Longmont, CO 80501

382 S Arthur Ave
Louisville, CO 80027

382 S Arthur Ave
Unit 100
Louisville, CO 80027

Interoperability endpoints

  • Direct secure messaging: p.kaye@gastrorockies.directbygreenway.com

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, 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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1114946639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S ARTHUR AVE",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800273094",
            "telephone_number": "303-604-5000",
            "fax_number": "720-890-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 48TH ST",
            "address_2": "SUITE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012711",
            "telephone_number": "303-604-5000",
            "fax_number": "720-890-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYE",
        "first_name": "PETER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.G.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "34974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "KAA1348",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01349745",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100007622",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.