Individual provider Active NPI

Brian Patrick Davis, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Boulder, CO
National Provider Identifier
1124473194
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
DR.0065919 Issued in CO
Practice address
4740 Pearl Pkwy Ste 200
Boulder, CO 80301-3080
Phone
(303) 449-2730
NPI assigned
Apr 27, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X BP10056453 TX
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X DR.0065919 CO Primary

Addresses

Primary practice location

4740 Pearl Pkwy Ste 200
Boulder, CO 80301-3080

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

1 Baylor Plz
Houston, TX 77030-3411
Phone (713) 798-4260

Other practice location 2

175 Inverness Dr W Ste 200
Englewood, CO 80112-5069
Phone (720) 848-0000

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
I20210729001553 CO Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 4082017934 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10056453TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Phillips County Hospital District Current Accepting new patients
Bouldercentre for Orthopedics PC Orthopaedic Surgery CurrentSince Sep 5, 2023 Accepting new patients
East Phillips County Hospital District Current Accepting new patients
Wray Community District Hospital CurrentSince Dec 18, 2025 Accepting new patients
Wray Community District Hospital CurrentSince Jan 1, 2024 Accepting new patients
Wray Community District Hospital CurrentSince Jan 1, 2024 Accepting new patients
East Phillips County Hospital District CurrentSince Sep 5, 2023 Accepting new patients
East Phillips County Hospital District CurrentSince Sep 5, 2023 Accepting new patients
Bouldercentre for Orthopedics Orthopaedic Surgery PastSince Feb 11, 2024 Accepting new patients
Broomfield Orthopedic Surgery Center, LLC PastSince May 21, 2023 Accepting new patients
East Phillips County Hospital District Past Accepting new patients
East Phillips County Hospital District Past Accepting new patients
East Phillips County Hospital District Past Accepting new patients

Locations

4740 Pearl Pkwy
Ste 200
Boulder, CO 80301

1185 State Highway 7
Broomfield, CO 80023
Phone (303) 442-2666

1185 State Highway 7
Ste 200
Broomfield, CO 80023

1001 E Johnson St
Holyoke, CO 80734
Phone (970) 854-2241

700 Main St
Wray, CO 80758
Phone (970) 332-3450

1017 W 7th St
Wray, CO 80758
Phone (970) 332-4811

Interoperability endpoints

  • Direct secure messaging: brian.davis.1@3497.direct.athenahealth.com
  • Direct secure messaging: brian.davis.1@15466.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/ntTIZxOIDS2tB2PUqr33FYQo0UWd2W9R/
  • FHIR API: https://api.platform.athenahealth.com/3497/brand/1/csg/21/fhir/r4

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 44

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

View all 44

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of Colorado School of Medicine, Denver, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wray Community District Hospital 31 clinicians
Healthone Clinic Services Orthopedic Specialists LLC 81 clinicians
Bouldercentre for Orthopedics PC 56 clinicians

Practice addresses (Care Compare)

1017 W 7TH St
Wray, CO 80758-1420
Phone (970) 332-4811

4700 Hale Pkwy
Suite 360
Denver, CO 80220-4041
Phone (720) 754-4410

4740 Pearl Pkwy
Suite 200
Boulder, CO 80301-3080
Phone (303) 449-2730

Hospital & facility affiliations

  • Melissa Memorial Hospital Hospital, Holyoke, CO, CCN 061305
  • Centura Health-St Anthony North Health Campus Hospital, Westminster, CO, CCN 060104
  • Boulder Community Health Hospital, Boulder, CO, CCN 060027
  • Wray Community District Hospital Hospital, Wray, CO, CCN 061309
  • HCA Healthone Rose Hospital, Denver, CO, CCN 060032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)42

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1124473194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 PEARL PKWY STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013080",
            "telephone_number": "303-449-2730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Baylor Plz",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303411",
            "country_code": "US",
            "telephone_number": "713-798-4260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Inverness Dr W Ste 200",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "801125069",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "BP10056453",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CO",
            "license": "DR.0065919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.