Individual provider Active NPI

Laura Beth Hundemann, PA-C

  • Physician Assistant
  • Boulder, CO
National Provider Identifier
1386919793
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2919 Valmont Rd Ste 204
Boulder, CO 80301-1350
Phone
(303) 938-1110
Fax
(303) 938-1145
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3395 CO
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2919 Valmont Rd Ste 204
Boulder, CO 80301-1350

Mailing address

2919 Valmont Rd # 204
Boulder, CO 80301-1350
Phone (303) 938-1110

Other identifiers 1

IdentifierTypeStateIssuer
70073040MedicaidCO

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120523000630 CO Practitioner - Physician Assistant 4385807643 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psyche PCGroup PAC ID 3971872888, 10 clinicians

Practice addresses (Care Compare)

1120 N Lincoln St
Suite 1601
Denver, CO 80203-2141
Phone (720) 432-9865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3395COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Afterours Inc CurrentSince Mar 27, 2018 Accepting new patients
Inpatient Consultants of Colorado, PC Physician Assistant Past Accepting new patients
Heritage Family Medicine Past Accepting new patients
Inpatient Consultants of Colorado PC Past Accepting new patients

Locations

6895 E Hampden Ave
Denver, CO 80224
Phone (303) 861-7878

Interoperability endpoints

  • Direct secure messaging: laura.hundemann@96713091579908.direct.elationemr.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1386919793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 VALMONT RD # 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011350",
            "telephone_number": "303-938-1110",
            "fax_number": "303-938-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 VALMONT RD STE 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011350",
            "telephone_number": "303-938-1110",
            "fax_number": "303-938-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNDEMANN",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3395",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70073040",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.