NPIMap

Individual provider Active NPI

Jennifer Berngard, MD

  • Family Medicine Physician
  • Boulder, CO
National Provider Identifier
1275897241
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0052896 Issued in CO
Practice address
2525 13TH St
Boulder, CO 80304-4104
Phone
(303) 449-6050
Fax
(720) 565-4132
NPI assigned
Jun 25, 2012
Last updated
May 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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 DR.0052896 CO Primary
Family Medicine Physician 207Q00000X A137281 CA

Addresses

Primary practice location

2525 13TH St
Boulder, CO 80304-4104

Mailing address

1735 S Public Rd Ste 203
Lafayette, CO 80026-7093
Phone (303) 665-3036

Other practice location 1

12710 Carmel Country Rd
San Diego, CA 92130-2153
Phone (858) 499-2707

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
I20190404002165 CO Practitioner - Family Practice 3577788553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Medical Center, PCGroup PAC ID 4183536204, 86 clinicians

Practice addresses (Care Compare)

2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A137281CAMDFamily Medicine Physician
DR.0052896COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Medical Center, P.C. CurrentSince Jan 26, 2026 Accepting new patients
Clinica Campesina Family Health Services Current Accepting new patients
Boulder Medical Center, P.C. CurrentSince Jan 26, 2026 Accepting new patients
Medical Center Pharmacy Inc Past Accepting new patients

Locations

2525 13th St
Boulder, CO 80304
Phone (303) 449-6050

2750 Broadway St
Boulder, CO 80304
Phone (303) 440-3000

4745 Arapahoe Ave
Ste 200
Boulder, CO 80303
Phone (303) 938-4710

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

1735 S Public Rd
Ste 203
Lafayette, CO 80026

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1275897241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 S PUBLIC RD STE 203",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267093",
            "telephone_number": "303-665-3036",
            "fax_number": "303-665-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 13TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044104",
            "telephone_number": "303-449-6050",
            "fax_number": "720-565-4132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12710 Carmel Country Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921302153",
            "country_code": "US",
            "telephone_number": "858-499-2707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNGARD",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0052896",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A137281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.