Individual provider Active NPI

David A Oppenheimer, M.D.

  • Diagnostic Radiology Physician
  • Boulder, CO
National Provider Identifier
1700851250
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25258 Issued in CO
Practice address
1100 Balsam Ave
Boulder, CO 80304-3404
Phone
(303) 440-2273
NPI assigned
Feb 20, 2006
Last updated
Mar 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25258 CO Primary

Addresses

Primary practice location

1100 Balsam Ave
Boulder, CO 80304-3404

Mailing address

36 Garden Ctr
Broomfield, CO 80020-1776
Phone (303) 465-0401

Other identifiers 3

IdentifierTypeStateIssuer
300048617OtherCOBRI MEDICARE RAILROAD
300061061OtherCODMSO CO MEDICARE RAILROAD
01252584MedicaidCO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000525 CO Practitioner - Diagnostic RadiologyPractitioner - Nuclear MedicinePractitioner - Interventional Radiology 8426944513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology, Nuclear Medicine
Education
Northwestern University Feinberg Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Radiologists Inc P CGroup PAC ID 4183510274, 13 clinicians

Practice addresses (Care Compare)

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 465-0401

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25258COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Radiologists Inc P C Diagnostic Radiology CurrentSince Jul 11, 1983 Accepting new patients
Bouldercentre for Orthopedics PC Past Accepting new patients

Locations

1100 Balsam Ave
Boulder, CO 80304
Phone (303) 415-7000

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

2880 Folsom St
Ste 100
Boulder, CO 80304
Phone (303) 247-9696

4740 Pearl Pkwy
Ste 110
Boulder, CO 80301
Phone (303) 449-2730

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

6685 Gunpark Dr
Ste 102
Boulder, CO 80301
Phone (303) 415-5199

36 Garden Ctr
Broomfield, CO 80020
Phone (303) 465-0401

101 Erie Pkwy
Erie, CO 80516
Phone (303) 415-5810

1000 W South Boulder Rd
Ste 105
Lafayette, CO 80026
Phone (303) 604-5031

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1700851250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 GARDEN CTR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201776",
            "telephone_number": "303-465-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BALSAM AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043404",
            "telephone_number": "303-440-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPENHEIMER",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "25258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRI MEDICARE RAILROAD",
            "identifier": "300048617",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMSO CO MEDICARE RAILROAD",
            "identifier": "300061061",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01252584",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.