Individual provider Active NPI

Justin P Meschler, MD

  • Anesthesiology Physician
  • Boulder, CO
National Provider Identifier
1124050265
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DR0055201 Issued in CO
Practice address
1100 Balsam Ave
Boulder, CO 80304
Phone
(303) 415-7000
Fax
(425) 407-1112
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 058074 GA
Pain Medicine (Anesthesiology) Physician 207LP2900X 058074 GA
Anesthesiology Physician 207L00000X DR0055201 CO Primary

Addresses

Primary practice location

1100 Balsam Ave
Boulder, CO 80304

Mailing address

PO Box 17389
Denver, CO 80217-0389
Phone (425) 407-1000

Other practice location 1

777 Hemlock St
Macon, GA 31201-2102
Phone (866) 507-5244

Other practice location 2

777 Hemlock St
Macon, GA 31201-2102
Phone (866) 507-5244

Other identifiers 2

IdentifierTypeStateIssuer
808556222AMedicaidGA
1124050265MedicaidCO

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR0055201COMDAnesthesiology Physician
058074GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Georgia Pulmonary Associates, LLC PastSince Aug 24, 2013 Accepting new patients
Boulder Pain Institute, PC Anesthesiology PastSince Jul 25, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAGGAA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1124050265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17389",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802170389",
            "telephone_number": "425-407-1000",
            "fax_number": "425-407-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BALSAM AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80304",
            "telephone_number": "303-415-7000",
            "fax_number": "425-407-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Hemlock St",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312012102",
            "country_code": "US",
            "telephone_number": "866-507-5244",
            "fax_number": "855-851-4405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Hemlock St",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312012102",
            "country_code": "US",
            "telephone_number": "866-507-5244",
            "fax_number": "855-851-4405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MESCHLER",
        "first_name": "JUSTIN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "058074",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "058074",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR0055201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808556222A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124050265",
            "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 Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.