NPIMap

Organization Active NPI

Boulder Community Health

Doing business as Community Medical Associates of BCH

  • Multi-Specialty Clinic/Center
  • Boulder, CO
National Provider Identifier
1609822030
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BOULDER COMMUNITY HEALTH
Doing business as
Community Medical Associates of BCH
Practice address
4990 Pearl East Cir Ste 100B
Boulder, CO 80301-2530
Phone
(303) 415-5300
Fax
(303) 415-4769
NPI assigned
May 26, 2006
Last updated
Jul 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
William A Munson
Title
Vice President & Chief Financial of
Phone
(303) 415-7433

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Medical Specialty Clinic/Center 261QM2500X
Physical Therapy Clinic/Center 261QP2000X
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

4990 Pearl East Cir Ste 100B
Boulder, CO 80301-2530

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-5300

Other names 1

  • Community Medical Associates of BCH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, ID3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20030902000042 CO Part A Provider - Hospital 6800707233 34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20040123000284 CO Part B Supplier - Clinic/Group Practice 6800707233 Receives reassigned benefits from 316 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Erie, CO; Superior, CO; Longmont, CO; Lafayette, CO; Boulder, CO
O20240325003352 ID Part B Supplier - Clinic/Group Practice 6800707233 Receives reassigned benefits from 1 practitioner
Practice locations: Meridian, ID; Boise, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609822030. Details of each certification follow.

Hospital certification: CCN 060027

Legal name
BOULDER COMMUNITY HEALTH
Doing business as
BOULDER COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 16, 2024
Beds
181
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
4747 Arapahoe Ave
Boulder, CO 80303-1131
Main/Primary Hospital Location
Hospital subgroups
General

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

Care Compare: Hospital

Medicare Care Compare
Listed as
Boulder Community HealthCCN 060027 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1100 Balsam Ave
Fl 2
Boulder, CO 80304

1136 Alpine Ave
Ste 205
Boulder, CO 80304
Phone (303) 546-6600

2800 Folsom St
Ste B
Boulder, CO 80304
Phone (303) 394-6830

2995 Baseline Rd
Ste 100
Boulder, CO 80303
Phone (303) 442-0355

311 Mapleton Ave
Ste 220
Boulder, CO 80304

4747 Arapahoe Ave
#1
Boulder, CO 80303

4747 Arapahoe Ave
#3
Boulder, CO 80303

4747 Arapahoe Ave
Ste 1N
Boulder, CO 80303

4801 Riverbend Rd
#300
Boulder, CO 80301
Phone (303) 415-7000

4801 Riverbend Rd
Ste 120B
Boulder, CO 80301
Phone (303) 415-8615

4990 Pearl East Cir
Ste 100
Boulder, CO 80301

4990 Pearl East Cir
Ste 100B
Boulder, CO 80301
Phone (303) 415-5300

5450 Western Ave
Ste B
Boulder, CO 80301

5495 Arapahoe Ave
Ste 100A
Boulder, CO 80303

16677 Lowell Blvd
Ste 100B
Broomfield, CO 80023

Dept 720
Denver, CO 80291

101 Erie Pkwy
Ste 10
Erie, CO 80516

1000 W South Boulder Rd
Ste 214
Lafayette, CO 80026
Phone (303) 415-4325

1000 W South Boulder Rd
Ste 216
Lafayette, CO 80026

2101 Ken Pratt Blvd
Ste 104B
Longmont, CO 80501

500 Discovery Pkwy
Ste 150
Superior, CO 80027
Phone (303) 425-9581

Ownership & related parties

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Perla Delgado Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
Robert Yates Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
Phillip P Distefano Individual Corporate OfficerBoard Member Jan 1, 2017
Grant Besser Individual Corporate OfficerVP Community Health & Engagement Oct 17, 2016
W-2 Managing EmployeeVP Community Health & Engagement Oct 17, 2016
Alyssa S Carlson Individual Corporate OfficerV.P. and Chief Medical Officer Nov 2, 2025
W-2 Managing EmployeeAd;MD; Nov 2, 2025
George Karakehian Individual Corporate OfficerBoard Member Jan 1, 2017
Elizabeth Cook Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
Susan Connelly Individual Corporate OfficerBoard of Directors Member Jan 1, 2023
Lawrence Novissimo Individual Corporate OfficerVP Ambulatory Services Jul 4, 2021
W-2 Managing EmployeeVP Ambulatory Services Jul 4, 2021
William a Munson Individual Corporate OfficerChief Financial Officer (Cfo) an Mar 18, 2008
W-2 Managing EmployeeChief Financial Officer (Cfo) an Mar 16, 2008
Diana Verrilli Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
Jay Pekarek Individual W-2 Managing EmployeeDelegated Official Nov 21, 2012
Teresa Cole Individual Corporate OfficerVP and Chief Information Officer Jun 16, 2024
W-2 Managing EmployeeVP and Chief Information Officer Jun 16, 2024
Robert J Vissers Individual Corporate OfficerCeo Jan 1, 2017
W-2 Managing EmployeeCeo Jan 1, 2017
John T Greff Individual Corporate OfficerBoard Member Jan 1, 2018
Doug Abel Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
Valerie E Lipetz Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
Boulder Community Health Organization, Boulder, CO Corporation, Non-profit Other Jul 1, 1966
Joel R Montbriand Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
John Fleagle Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
Deborah S Lund Individual Corporate OfficerBoard Member Jan 1, 2018
Jackie Attlesey-Pries Individual Corporate OfficerVP Chief Nursing Officer Sep 6, 2011
W-2 Managing EmployeeVP Chief Nursing Officer Sep 6, 2011
Chris Hazlitt Individual Corporate OfficerBoard of Directors Member Jan 1, 2024
Mardi Moore Individual 5% Or Greater Direct Ownership InterestBoard Member Jan 1, 2019
Corporate OfficerBoard of Directors Member Jan 1, 2024
Sarah E Meshak Individual Corporate OfficerVP and General Counsel Aug 31, 2009
W-2 Managing EmployeeVP and General Counsel Aug 31, 2009
Nancy Stevens Individual 5% Or Greater Direct Ownership InterestBoard Member Jan 1, 2019
Corporate OfficerBoard of Directors Member Jan 1, 2024

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Boulder Community HospitalBoulder, CO, CCN 060027 Hospital Other Jul 1, 1966
Boulder Community Health Behavioral Health Ip UnitBoulder, CO, CCN 06S027 Hospital Other Jul 1, 1966

Owned or controlled facilities with NPI records 33

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 33

Practitioners & affiliated clinicians

Practitioners 392

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 392

Affiliated clinicians 720

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 720

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1609822030",
    "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": "303-415-5300",
            "fax_number": "303-415-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 PEARL EAST CIR STE 100B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012530",
            "telephone_number": "303-415-5300",
            "fax_number": "303-415-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT & CHIEF FINANCIAL OF",
        "authorized_official_telephone_number": "303-415-7433"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Associates of BCH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Medical Associates of BCH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.