Bro - Boulder LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

BRO - BOULDER LLC

Practice address

5420 Arapahoe Ave Ste a
Boulder, CO 80303-1250

Phone

(720) 463-0567

Fax

(303) 494-5371

NPI assigned

Jun 14, 2023

Organization subpart

Yes

Parent organization

BREAKTHROUGH REGENERATIVE ORTHOPEDICSAs reported in NPPES

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

Authorized official

Name

Dr. Timothy J Mazzola, MD

Title

Sole Owner

Phone

(720) 463-0567

Specialties & licenses 1

Addresses

Part of

Regenerative Orthopedics S

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22510/brand/1/csg/1/fhir/r4

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Breakthrough Regenerative Orthopedics

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Boulder, CO
  • NPI 1497261523
  NPPES parent name

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1194409441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 ARAPAHOE AVE STE A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031250",
            "telephone_number": "720-463-0567",
            "fax_number": "303-494-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 ARAPAHOE AVE STE A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031250",
            "telephone_number": "720-463-0567",
            "fax_number": "303-494-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRO - BOULDER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BREAKTHROUGH REGENERATIVE ORTHOPEDICS",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "MAZZOLA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "720-463-0567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William B Britt, O.D.
• Sarah Brittain
• Leslie M Britton, PT
• Michael Robert Britton
• Brittyn Coleman Nutrition
• Erica Brochstein
• Brock Westover, D.D.S., M-Ed, PLLC
• Tara Faith Brockman, L.AC.
• Brett Broda, DDS
• Julie Anne Brody, PHD

• Sports Medicine (Orthopaedic Surgery) Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.