NPIMap

Organization Active NPI

Good Samaritan Medical Center, LLC

Doing business as Good Samaritan Medical Center

  • General Acute Care Hospital
  • Lafayette, CO
National Provider Identifier
1407845035
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0570 Issued in CO
Legal business name
GOOD SAMARITAN MEDICAL CENTER, LLC
Doing business as
Good Samaritan Medical Center
Practice address
200 Exempla Cir
Lafayette, CO 80026-3370
Phone
(303) 689-4000
NPI assigned
Oct 17, 2005
Last updated
Apr 28, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SCL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Hilda Dalfonso
Title
VP Finance
Phone
(303) 689-5210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0570 CO Primary

Addresses

Primary practice location

200 Exempla Cir
Lafayette, CO 80026-3370

Mailing address

200 Exempla Cir
Lafayette, CO 80026-3370
Phone (303) 689-4000

Other names 1

  • Good Samaritan Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051102001154 CO Part B Supplier - Clinic/Group Practice 7618995275 Receives reassigned benefits from 34 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lafayette, CO
O20070828000160 CO Part A Provider - Hospital 7618995275 Practice locations: Lafayette, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407845035. Details of each certification follow.

Hospital certification: CCN 060116

Legal name
GOOD SAMARITAN MEDICAL CENTER, LLC
Doing business as
INTERMOUNTAIN HEALTH GOOD SAMARITAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 8, 2004
Last certification
Oct 27, 2023
Beds
234
Ownership / control type
Private (not for profit)
Organization structure
LLCNon-profit
Incorporated
Oct 29, 2002 in CO
Enrollment address
200 Exempla Cir
Lafayette, CO 80026-3370
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Good Samaritan Medical Center LLCCCN 060116 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Medical Ctr3 organizations share this tax ID, including this one
Part of
Sisters of Charity of Leavenworth Health System Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2600 Campus Dr
Lafayette, CO 80026
Phone (303) 689-4000

300 Exempla Cir
Ste 240
Lafayette, CO 80026
Phone (303) 689-6580

300 Exempla Cir
Ste 308
Lafayette, CO 80026
Phone (303) 689-6560

340 Exempla Cir
#1
Lafayette, CO 80026
Phone (303) 673-1600

340 Exempla Cir
Fl 1
Lafayette, CO 80026
Phone (303) 673-1600

340 Exempla Cir
Fl 2
Lafayette, CO 80026
Phone (303) 689-6580

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kevin Jenkins Individual Corporate OfficerPresident Mar 3, 2025
W-2 Managing EmployeePresident Mar 3, 2025
Brooke Bellamy Individual Corporate OfficerDirector of Finance May 25, 2025
W-2 Managing EmployeeDirector of Finance May 25, 2025
Integrity Health Organization, Broomfield, CO Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 1, 2024
Intermountain Front Range, Inc. Organization, Broomfield, CO Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2024 100%
Intermountain Health Care, Inc Organization, Salt Lake City, UT Corporation, Non-profit, Chain home office Operational/Managerial Control Apr 1, 2022

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

Practitioners & affiliated clinicians

Practitioners 111

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 111

Affiliated clinicians 438

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 438

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1407845035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-689-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-689-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCL HEALTH",
        "enumeration_date": "2005-10-17",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "DALFONSO",
        "authorized_official_first_name": "HILDA",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "303-689-5210"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CO",
            "license": "0570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Good Samaritan Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.