Individual provider Active NPI

Lisabeth C Hall, MD

  • Internal Medicine Physician
  • Lafayette, CO
National Provider Identifier
1376578187
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0051961 Issued in CO
Practice address
1000 W South Boulder Rd
Suite 214
Lafayette, CO 80026-2752
Phone
(303) 604-6669
Fax
(303) 604-5095
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0051961 CO Primary
Internal Medicine Physician 207R00000X 54785 CA

Addresses

Primary practice location

1000 W South Boulder Rd
Suite 214
Lafayette, CO 80026-2752

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 415-4325

Other identifiers 1

IdentifierTypeStateIssuer
49452258MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130413000108 CO Practitioner - Internal Medicine 4486657574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2003
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

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027
  • Adventhealth Avista Hospital, Louisville, CO, CCN 060103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0051961COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Mar 4, 2013 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince Mar 4, 2013 Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770

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

1000 W South Boulder Rd
Ste 214
Lafayette, CO 80026
Phone (303) 415-4325

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

Organizations & group practices 4

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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1376578187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-4325",
            "fax_number": "303-661-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W SOUTH BOULDER RD",
            "address_2": "SUITE 214",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262752",
            "telephone_number": "303-604-6669",
            "fax_number": "303-604-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "LISABETH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0051961",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "54785",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49452258",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.