Individual provider Active NPI

Melody Bourret

  • Psychiatric/Mental Health Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1548926488
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0998810-NP Issued in CO
Practice address
2710 Regis Dr
Boulder, CO 80305-5325
Phone
(303) 513-2995
NPI assigned
Nov 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0998810-NP CO Primary

Addresses

Primary practice location

2710 Regis Dr
Boulder, CO 80305-5325

Mailing address

2710 Regis Dr
Boulder, CO 80305-5325
Phone (303) 513-2995

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822000901 CO Practitioner - Nurse Practitioner 1850753914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joseph Yeretsian PCGroup PAC ID 5597893313, 13 clinicians

Practice addresses (Care Compare)

155 Boardwalk Dr
Suite 400
Fort Collins, CO 80525-3040
Phone (970) 549-0235

4770 Baseline Rd
Suite 300
Boulder, CO 80303-2669
Phone (720) 798-4516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0998810-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Yeretsian, P.C. CurrentSince Aug 2, 2023 Accepting new patients

Locations

4770 Baseline Rd
Ste 300
Boulder, CO 80303
Phone (720) 798-4516

155 Boardwalk Dr
Ste 400
Fort Collins, CO 80525
Phone (970) 549-0235

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1548926488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 REGIS DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055325",
            "telephone_number": "303-513-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 REGIS DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055325",
            "telephone_number": "303-513-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURRET",
        "first_name": "MELODY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0998810-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.