NPIMap

Individual provider Active NPI

Melissa Marie Fountain, PA-C

  • Medical Physician Assistant
  • Lafayette, CO
National Provider Identifier
1609327493
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA0004816 Issued in CO
Practice address
1000 W South Boulder Rd Ste 110
Lafayette, CO 80026-2753
Phone
(303) 415-4355
NPI assigned
Oct 17, 2016
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA0004816 CO Primary

Addresses

Primary practice location

1000 W South Boulder Rd Ste 110
Lafayette, CO 80026-2753

Mailing address

1000 W South Boulder Rd Ste 110
Lafayette, CO 80026-2753
Phone (303) 415-4355

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
I20180228000542 CO Practitioner - Physician Assistant 9234490657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
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
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

1000 W S Boulder Rd
Lafayette, CO 80026-2753

1755 48TH St
Suite 200
Boulder, CO 80301-2712
Phone (303) 415-7450

8601 Turnpike Dr
Suite 204
Westminster, CO 80031-7043
Phone (303) 222-4312

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0004816COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Jan 6, 2025 Accepting new patients
Boulder Community Health CurrentSince Jan 6, 2025 Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

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

1000 W South Boulder Rd
Ste 110
Lafayette, CO 80026
Phone (303) 415-4355

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1609327493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W SOUTH BOULDER RD STE 110",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262753",
            "telephone_number": "303-415-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W SOUTH BOULDER RD STE 110",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262753",
            "telephone_number": "303-415-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA0004816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.