NPIMap

Individual provider Active NPI

Daniel Mejia, MD

  • Family Medicine Physician
  • Superior, CO
National Provider Identifier
1265993679
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0073770 Issued in CO
Practice address
3 Superior Dr Ste 100B
Superior, CO 80027-8653
Phone
(303) 415-8940
Fax
(303) 425-9259
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 192062 AK
Family Medicine Physician 207Q00000X DR.0073770 CO Primary

Addresses

Primary practice location

3 Superior Dr Ste 100B
Superior, CO 80027-8653

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-8940

Other practice location 1

2211 E Northern Lights Blvd Ste 101
Anchorage, AK 99508-4192
Phone (907) 279-8486

Other practice location 2

1500 S Main St
Fort Worth, TX 76104-4941
Phone (817) 702-1244

Other identifiers 1

IdentifierTypeStateIssuer
1732943MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240917002295 CO Practitioner - Family Practice 5395111496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

3 Superior Dr
Suite 100B
Superior, CO 80027-8653
Phone (303) 415-8940

8601 Turnpike Dr
Westminster, CO 80031-7043
Phone (303) 222-4312

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as apm
Quality
90.42
Promoting interoperability
91.56
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
192062AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Oct 1, 2024 Accepting new patients
Boulder Community Health CurrentSince Oct 1, 2024 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

3 Superior Dr
Ste 100B
Superior, CO 80027
Phone (303) 415-8940

Organizations & group practices 5

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.

Hospital & facility affiliations 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1265993679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9049",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803019049",
            "telephone_number": "303-415-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SUPERIOR DR STE 100B",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800278653",
            "telephone_number": "303-415-8940",
            "fax_number": "303-425-9259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 E Northern Lights Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084192",
            "country_code": "US",
            "telephone_number": "907-279-8486",
            "fax_number": "907-677-5614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044941",
            "country_code": "US",
            "telephone_number": "817-702-1244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "192062",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0073770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1732943",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, CO

Sources for this page

Verify at the official NPI Registry.