NPIMap

Individual provider Active NPI

Sonika Momin, M.D.

  • Family Medicine Physician
  • Superior, CO
National Provider Identifier
1548655640
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0067915 Issued in CO
Practice address
3 Superior Dr Ste 100B
Superior, CO 80027-8653
Phone
(303) 415-8940
Fax
(303) 425-9259
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R6052 TX
Family Medicine Physician 207Q00000X DR.0067915 CO Primary

Addresses

Primary practice location

3 Superior Dr Ste 100B
Superior, CO 80027-8653

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-8940

Other practice location 1

11714 Wilson Parke Ave Ste 150
Austin, TX 78726-4061
Phone (512) 346-6611

Other identifiers 2

IdentifierTypeStateIssuer
387030505MedicaidTX
387030504MedicaidTX

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
I20220316000392 CO Practitioner - Family Practice 2264780865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

3 Superior Dr
Suite 100B
Superior, CO 80027-8653
Phone (303) 415-8940

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

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 Apr 25, 2022 Accepting new patients
Boulder Community Health CurrentSince Apr 25, 2022 Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

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

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

3 Superior Dr
Ste 100B
Superior, CO 80027
Phone (303) 415-8940

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": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1548655640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9049",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803019049",
            "telephone_number": "303-415-8940",
            "fax_number": "303-425-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SUPERIOR DR STE 100B",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800278653",
            "telephone_number": "303-415-8940",
            "fax_number": "303-425-9259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11714 Wilson Parke Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787264061",
            "country_code": "US",
            "telephone_number": "512-346-6611",
            "fax_number": "512-406-6267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOMIN",
        "first_name": "SONIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R6052",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0067915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387030505",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387030504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, CO

Sources for this page

Verify at the official NPI Registry.