NPIMap

Individual provider Active NPI

Bryan J Reynolds, M.D.

  • Interventional Cardiology Physician
  • Boulder, CO
National Provider Identifier
1396853727
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
DR.0039638 Issued in CO
Practice address
4743 Arapahoe Ave Ste 201
Boulder, CO 80303-1128
Phone
(303) 442-2395
Fax
(303) 442-5232
NPI assigned
Aug 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X DR.0039638 CO Primary
Cardiovascular Disease Physician 207RC0000X DR.0039638 CO

Addresses

Primary practice location

4743 Arapahoe Ave Ste 201
Boulder, CO 80303-1128

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 442-2395

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
I20100802000979 CO Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1557494283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of New Mexico School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

4743 Arapahoe Ave
Suite 201
Boulder, CO 80303-1128
Phone (303) 442-2395

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince Jul 5, 2011 Accepting new patients
Boulder Community Health CurrentSince Jul 5, 2011 Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Ekg Cardiovascular Disease Past Accepting new patients

Locations

2505 4th St
Boulder, CO 80304
Phone (303) 441-5237

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

4743 Arapahoe Ave
Ste 201
Boulder, CO 80303

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

1100 Balsam Ave
Boulder, CO 80304
Phone (303) 415-7000

101 Erie Pkwy
Ste 201A
Erie, CO 80516

101 Erie Pkwy
Erie, CO 80516
Phone (303) 415-5170

1000 W South Boulder Rd
Ste 216
Lafayette, CO 80026

2101 Ken Pratt Blvd
Ste 104
Longmont, CO 80501
Phone (303) 776-1532

2101 Ken Pratt Blvd
Longmont, CO 80501
Phone (303) 415-4155

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": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1396853727",
    "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": "303-442-2395",
            "fax_number": "303-442-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4743 ARAPAHOE AVE STE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031128",
            "telephone_number": "303-442-2395",
            "fax_number": "303-442-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "BRYAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CO",
            "license": "DR.0039638",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "DR.0039638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.