Individual provider Active NPI

Paul Patrick Braunlin, PT

  • Orthopedic Physical Therapist
  • Fort Collins, CO
National Provider Identifier
1497997340
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
3947 Issued in CO
Practice address
4674 Snow Mesa Dr
Suite 200
Fort Collins, CO 80528-8615
Phone
(970) 495-8450
Fax
(970) 297-6598
NPI assigned
Mar 24, 2009
Last updated
Jan 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 3947 CO Primary

Addresses

Primary practice location

4674 Snow Mesa Dr
Suite 200
Fort Collins, CO 80528-8615

Mailing address

4674 Snow Mesa Dr
Suite 200
Fort Collins, CO 80528-8615
Phone (970) 495-8450

Other identifiers 1

IdentifierTypeStateIssuer
62175114MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170206000332 CO Practitioner - Physical Therapist in Private Practice 7012290695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2315 E Harmony Rd
Fort Collins, CO 80528-8620

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3947COMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 1, 2016 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 1, 2016 Accepting new patients
Poudre Valley Medical Group, LLC Physical Therapist PastSince Aug 1, 2020 Accepting new patients

Locations

151 W Lake St
Ste 1500
Fort Collins, CO 80524
Phone (970) 237-8200

2315 E Harmony Rd
Ste 170
Fort Collins, CO 80528
Phone (970) 495-8450

4674 Snow Mesa Dr
Ste 200
Fort Collins, CO 80528
Phone (970) 266-3650

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 1
Greeley, CO 80634
Phone (970) 652-2477

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1455 Main St
Ste 160
Windsor, CO 80550
Phone (970) 674-6514

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1497997340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-495-8450",
            "fax_number": "970-297-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-495-8450",
            "fax_number": "970-297-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUNLIN",
        "first_name": "PAUL",
        "middle_name": "PATRICK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "3947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62175114",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.