Individual provider Active NPI

Michael J Perlman

  • Internal Medicine Physician
  • Boulder, CO
National Provider Identifier
1346384138
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31958 Issued in CO
Practice address
580 Mohawk Dr
Boulder, CO 80303-3712
Phone
(303) 743-5855
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31958 CO Primary

Addresses

Primary practice location

580 Mohawk Dr
Boulder, CO 80303-3712

Mailing address

580 Mohawk Dr
Boulder, CO 80303-3712
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
007010OtherKAISER-COMMERCIAL NUMBER
01319581MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31598COMDAllergy & Immunology Physician
31958COMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1346384138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 MOHAWK DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803033712",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 MOHAWK DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803033712",
            "telephone_number": "303-743-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLMAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "31958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "007010",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01319581",
            "state": "CO"
        }
    ],
    "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 Mar 15, 2011; 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.