Individual provider Active NPI

Lauren Rosso, PA

  • Physician Assistant
  • Boulder, CO
National Provider Identifier
1699420919
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006940 Issued in CO
Practice address
2750 Broadway St
Boulder, CO 80304-3586
Phone
(303) 440-3083
Fax
(303) 440-3100
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0006940 CO Primary

Addresses

Primary practice location

2750 Broadway St
Boulder, CO 80304-3586

Mailing address

2750 Broadway St
Boulder, CO 80304-3586
Phone (303) 440-3083

Other names 1

  • Ms. Lauren Peterson Former name

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
I20220322000026 CO Practitioner - Physician Assistant 5698160042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Medical Center, PCGroup PAC ID 4183536204, 86 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0006940COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Medical Center, P.C. CurrentSince Oct 9, 2023 Accepting new patients
Boulder Medical Center, P.C. CurrentSince Oct 9, 2023 Accepting new patients
Medical Center Pharmacy Inc Past Accepting new patients
Boulder Medical Center, P.C. Past Accepting new patients

Locations

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

Organizations & group practices 4

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.

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1699420919",
    "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": "803043586",
            "telephone_number": "303-440-3083",
            "fax_number": "303-440-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043586",
            "telephone_number": "303-440-3083",
            "fax_number": "303-440-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSO",
        "first_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "PETERSON",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.