Individual provider Active NPI

Lauren Roseann Goldsmith, PHD

  • Psychologist
  • Boulder, CO
National Provider Identifier
1700951159
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2397 Issued in CO
Practice address
350 Broadway St
Ste 210
Boulder, CO 80305-3338
Phone
(303) 449-4496
Fax
(303) 444-0366
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2397 CO Primary

Addresses

Primary practice location

350 Broadway St
Ste 210
Boulder, CO 80305-3338

Mailing address

1335 Norwood Ave
Boulder, CO 80304-1209
Phone (303) 931-3021

Other identifiers 1

IdentifierTypeStateIssuer
65920023MedicaidCO

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040420001124 CO Practitioner - Clinical Psychologist 5193710879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

350 Broadway St
Suite 210
Boulder, CO 80305-3338
Phone (303) 449-4496

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2397COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Connections of Texas, PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1700951159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 NORWOOD AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803041209",
            "telephone_number": "303-931-3021",
            "fax_number": "303-444-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BROADWAY ST",
            "address_2": "STE 210",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803053338",
            "telephone_number": "303-449-4496",
            "fax_number": "303-444-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "LAUREN",
        "middle_name": "ROSEANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65920023",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.