Active NPI
Andrea K Malanowski, MD
- Clinic/Center
- Boulder, CO
National Provider Identifier
1497872436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 28482
- Practice address
- 119 Campus
Boulder, CO 80309-0119 - Phone
- (303) 492-5101
- NPI assigned
- Mar 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 28482 | CO | Primary |
Addresses
Primary practice location
119 Campus
Boulder, CO 80309-0119
Mailing address
1042 Berea Dr
Boulder, CO 80305-6535
Phone (303) 494-8407
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28482 | CO | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497872436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1042 BEREA DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "803056535",
"telephone_number": "303-494-8407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 CAMPUS",
"city": "BOULDER",
"state": "CO",
"postal_code": "803090119",
"telephone_number": "303-492-5101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALANOWSKI",
"first_name": "ANDREA",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "CO",
"license": "28482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.