Timothy Joseph Mazzola, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

41636 Issued in CO

Practice address

5420 Arapahoe Ave Ste a
Boulder, CO 80303-1250

Phone

(720) 463-0567

Fax

(303) 494-5371

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: timothy.mazzola.1@22510.direct.athenahealth.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/7771e67c-eed3-4c07-8b39-4ee1de7dfb76/

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.

• Pagosa Springs Family Medical Center

  • Specialist
  • Pagosa Springs, CO
  • NPI 1235174392
  NPD (past)
• Pagosa Springs Family Medicine Center PC

  • Specialist
  • Pagosa Springs, CO
  • NPI 1023133824
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1437130424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21928",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154116",
            "telephone_number": "720-463-0567",
            "fax_number": "303-494-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 ARAPAHOE AVE STE A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031250",
            "telephone_number": "720-463-0567",
            "fax_number": "303-494-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOLA",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CO",
            "license": "41636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Mayer
• Sara C. Mayer, MSW/LCSW
• Anna Petit Maynard
• Meredith Harkess Mayo, MD
• Katharine Michelle Mazuy, MA, LPC
• Jenna Lynne McAfee, FNP-C
• Mathias McAfee
• Hunter McAlpine
• Sean McAndrew, MA
• Terry Lynn McArthur, RD

• Sports Medicine (Family Medicine) Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Sports Medicine (Family Medicine) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.