NPIMap

Organization Active NPI

Boulder Valley Ear Nose & Throat Associates PC

  • Otolaryngology Physician
  • Boulder, CO
National Provider Identifier
1194948026
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
BOULDER VALLEY EAR NOSE & THROAT ASSOCIATES PC
Practice address
4745 Arapahoe Ave
Suite 130
Boulder, CO 80303-1080
Phone
(303) 443-2771
Fax
(303) 443-2784
NPI assigned
Apr 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sun Young Monkman
Title
Practice Manager
Phone
(303) 443-2771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

4745 Arapahoe Ave
Suite 130
Boulder, CO 80303-1080

Mailing address

4745 Arapahoe Ave
Suite 130
Boulder, CO 80303-1080
Phone (303) 443-2771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040506001340 CO Part B Supplier - Clinic/Group Practice 9234128216 Receives reassigned benefits from 17 practitioners
Practice locations: Boulder, CO; Lafayette, CO; Louisville, CO

National Provider Directory

National Provider Directory

Locations

4745 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

300 Exempla Cir
Ste 210
Lafayette, CO 80026
Phone (303) 443-2771

300 Exempla Cir
Ste 270
Lafayette, CO 80026
Phone (303) 443-2771

90 Health Park Dr
Ste 220
Louisville, CO 80027
Phone (303) 443-2771

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194948026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE",
            "address_2": "SUITE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031080",
            "telephone_number": "303-443-2771",
            "fax_number": "303-443-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE",
            "address_2": "SUITE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031080",
            "telephone_number": "303-443-2771",
            "fax_number": "303-443-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER VALLEY EAR NOSE & THROAT ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONKMAN",
        "authorized_official_first_name": "SUN YOUNG",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "303-443-2771"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.