Individual provider Active NPI

Damon J Negri

  • Emergency Medicine Physician
  • Boulder, CO
National Provider Identifier
1124193453
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0025479 Issued in CO
Practice address
4747 Arapahoe Avenue
Boulder, CO 80303-1133
Phone
(303) 306-7783
Fax
(303) 306-7753
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 8321 NH
Emergency Medicine Physician 207P00000X DR.0025479 CO Primary

Addresses

Primary practice location

4747 Arapahoe Avenue
Boulder, CO 80303-1133

Mailing address

PO Box 173894
Denver, CO 80217-3894
Phone (303) 306-7783

Other identifiers 6

IdentifierTypeStateIssuer
0194671MedicaidMA
275270099MedicaidME
30007778MedicaidNH
930050636OtherNHRAILROAD
0105112Y0NH07OtherNHANTHEM
0105112Y0NH08OtherNHBCBS OF NH

Other names 1

  • Damon J Negri Professional name

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
8321NHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Emergency Physicians PC Emergency Medicine Past Accepting new patients
Boulder Community Health Past Accepting new patients
Borthwick Emergency Physicians, LLC Emergency Medicine PastSince Dec 15, 2019 Accepting new patients
Portsmouth Emergency Physicians PC Past Accepting new patients

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1124193453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173894",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173894",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 ARAPAHOE AVENUE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031133",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRI",
        "first_name": "DAMON",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "8321",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0025479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0194671",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275270099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30007778",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "930050636",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0105112Y0NH07",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NH",
            "identifier": "0105112Y0NH08",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAMON",
            "last_name": "NEGRI",
            "middle_name": "J",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Nov 1, 2016; 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.