NPIMap

Organization Active NPI

Boulder Medical Center, P.C.

  • Multi-Specialty Clinic/Center
  • Louisville, CO
National Provider Identifier
1699308452
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BOULDER MEDICAL CENTER, P.C.
Practice address
80 Health Park Dr Ste 100
Louisville, CO 80027-4644
Phone
(303) 673-0448
NPI assigned
Feb 19, 2020
Last updated
Feb 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Authorized official

Name
Casandra Richards
Title
Credentialing Specialist
Phone
(303) 440-3076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

80 Health Park Dr Ste 100
Louisville, CO 80027-4644

Mailing address

2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3000

Other practice location 1

80 Health Park Dr Ste 200
Louisville, CO 80027-4644
Phone (303) 666-2710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000512 CO Part B Supplier - Clinic/Group Practice 4183536204 Receives reassigned benefits from 99 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Erie, CO; Louisville, CO; Boulder, CO; Longmont, CO

Other NPIs on the same Medicare enrollment 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0893569Boulder Medical Center80 Health Park Dr, Suite 100, Louisville, CO 80027Provider-performed microscopyMar 10, 2028

National Provider Directory

National Provider Directory

Locations

80 Health Park Dr
Ste 100200
Louisville, CO 80027

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1699308452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-440-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HEALTH PARK DR STE 100",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800274644",
            "telephone_number": "303-673-0448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Health Park Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800274644",
            "country_code": "US",
            "telephone_number": "303-666-2710",
            "fax_number": "303-673-0438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOULDER MEDICAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "CASANDRA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "303-440-3076"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.