Active NPI
Melissa Ann Kushlak, D.O.
- Obstetrics & Gynecology Physician
- Boulder, CO
National Provider Identifier
1659664175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 15456
- Practice address
- 4745 Arapahoe Ave Ste 320
Boulder, CO 80303-1082 - Phone
- (303) 441-0587
- Fax
- (303) 996-0801
- NPI assigned
- May 17, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 15456 | FL | Primary |
Addresses
Primary practice location
4745 Arapahoe Ave Ste 320
Boulder, CO 80303-1082
Mailing address
PO Box 9049
Boulder, CO 80301-9049
Phone (303) 441-0587
Other practice location 1
1445 Sheldon Rd
Suite 301
Grand Haven, MI 49417-2480
Phone (616) 847-2500
Other practice location 2
2466 E Commercial Blvd Ste 101
Ft Lauderdale, FL 33308
Phone (954) 776-4877
Other practice location 3
101 Erie Pkwy Ste 201B
Erie, CO 80516-4072
Phone (303) 441-0587
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201116001254 | CO | Practitioner - Obstetrics/Gynecology | 1254550882 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Michigan State University College of Osteopathic Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Boulder Community Health
Practice addresses (Care Compare)
4745 Arapahoe Ave
Suite 320
Boulder, CO 80303-1082
Phone (303) 441-0587
Hospital & facility affiliations
- Boulder Community Health
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15456 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients |
Locations
4745 Arapahoe Ave
Ste 320
Boulder, CO 80303
Phone (303) 441-0587
1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450
101 Erie Pkwy
Ste 201B
Erie, CO 80516
Phone (303) 441-0587
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1609822030
-
- Psychiatric Hospital Unit
- Boulder, CO
- NPI 1760595086
-
- Medical Specialty Clinic/Center
- Superior, CO
- NPI 1508413196
-
- Primary Care Clinic/Center
- Boulder, CO
- NPI 1740837137
-
- Medical Specialty Clinic/Center
- Boulder, CO
- NPI 1407685498
Hospital & facility affiliations 34
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1659664175",
"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": "303-441-0587",
"fax_number": "303-996-0801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4745 ARAPAHOE AVE STE 320",
"city": "BOULDER",
"state": "CO",
"postal_code": "803031082",
"telephone_number": "303-441-0587",
"fax_number": "303-996-0801"
}
],
"practiceLocations": [
{
"address_1": "1445 Sheldon Rd",
"address_2": "Suite 301",
"address_purpose": "LOCATION",
"city": "Grand Haven",
"state": "MI",
"postal_code": "494172480",
"country_code": "US",
"telephone_number": "616-847-2500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2466 E Commercial Blvd Ste 101",
"address_purpose": "LOCATION",
"city": "Ft Lauderdale",
"state": "FL",
"postal_code": "33308",
"country_code": "US",
"telephone_number": "954-776-4877",
"fax_number": "954-776-1399",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "101 Erie Pkwy Ste 201B",
"address_purpose": "LOCATION",
"city": "Erie",
"state": "CO",
"postal_code": "805164072",
"country_code": "US",
"telephone_number": "303-441-0587",
"fax_number": "303-996-0801",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUSHLAK",
"first_name": "MELISSA",
"middle_name": "ANN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-17",
"last_updated": "2022-09-29",
"certification_date": "2022-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "15456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.