NPIMap

Organization Active NPI

Boulder Community Health

Doing business as Boulder Medical Center Lab

  • Clinical Medical Laboratory
  • Boulder, CO
National Provider Identifier
1144878208
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
BOULDER COMMUNITY HEALTH
Doing business as
Boulder Medical Center Lab
Practice address
2750 Broadway St
Boulder, CO 80304-3573
Phone
(303) 415-4240
Fax
(303) 415-4248
NPI assigned
Aug 30, 2019
Last updated
Aug 30, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BOULDER COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Authorized official

Name
Jay Pekarek
Title
Reimbursement Specialist
Phone
(303) 415-4233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

2750 Broadway St
Boulder, CO 80304-3573

Mailing address

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-4700

Other names 1

  • BOULDER MEDICAL CENTER LAB Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0913765Boulder Medical Center2750 Broadway, Boulder, CO 80304Provider-performed microscopyNov 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
BCH Physician Clinics82 organizations share this tax ID, including this one
Part of
BCH Physician Clinics

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567123200000",
    "number": "1144878208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 ARAPAHOE AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031131",
            "telephone_number": "303-415-4700",
            "fax_number": "303-415-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-415-4240",
            "fax_number": "303-415-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOULDER COMMUNITY HEALTH",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A",
        "authorized_official_last_name": "PEKAREK",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "REIMBURSEMENT SPECIALIST",
        "authorized_official_telephone_number": "303-415-4233"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BOULDER MEDICAL CENTER LAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.