NPIMap

Individual provider Active NPI

Kurt Douglas Noteboom, PA-C, ATC

  • Physician Assistant
  • Louisville, CO
National Provider Identifier
1124135264
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
738 Issued in CO
Practice address
80 Health Park Dr
#230
Louisville, CO 80027-9584
Phone
(303) 665-2603
Fax
(303) 665-2605
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10057 MN
Physician Assistant 363A00000X 738 CO Primary

Addresses

Primary practice location

80 Health Park Dr
#230
Louisville, CO 80027-9584

Mailing address

8426 Zinnia CT
Arvada, CO 80005-1100
Phone (303) 952-9926

Other identifiers 1

IdentifierTypeStateIssuer
322152100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121228000157 ND Practitioner - Physician Assistant 7113977109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

1720 University Dr S
Fargo, ND 58103-4940
Phone (701) 234-2000

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Perham Health Hospital, Perham, MN, CCN 241373

Merit-based Incentive Payment System (MIPS)

Final score
87.39 of 100Reported as group
Quality
91.62
Promoting interoperability
100
Improvement activities
40
Cost
66.36

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
738COMDMarriage & Family Therapist
10057MNMDPhysician Assistant
832MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Nov 2, 2012 Accepting new patients
Sanford Medical Center Fargo CurrentSince Nov 2, 2012 Accepting new patients
Orthopedic Centers of Colorado, LLC Physician Assistant Past Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients
Colorado Orthopaedics PC Past Accepting new patients

Locations

2301 25th St SW
Fargo, ND 58103
Phone (701) 234-7400

1720 University Dr S
Fargo, ND 58103
Phone (701) 280-4140

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16409/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1124135264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8426 ZINNIA CT",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800051100",
            "telephone_number": "303-952-9926",
            "fax_number": "303-436-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HEALTH PARK DR",
            "address_2": "#230",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279584",
            "telephone_number": "303-665-2603",
            "fax_number": "303-665-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTEBOOM",
        "first_name": "KURT",
        "middle_name": "DOUGLAS",
        "credential": "PA-C, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10057",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322152100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

Verify at the official NPI Registry.