NPIMap

Individual provider Active NPI

Alicia E Maltzman, N.P.

  • Family Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1710960380
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0003689-NP Issued in CO
Practice address
4800 Riverbend Rd
Suite 200
Boulder, CO 80301-2636
Phone
(303) 415-8850
Fax
(303) 415-8870
NPI assigned
Nov 28, 2005
Last updated
Nov 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0003689-NP CO
Family Nurse Practitioner 363LF0000X APN.0003689-NP CO Primary

Addresses

Primary practice location

4800 Riverbend Rd
Suite 200
Boulder, CO 80301-2636

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 415-8850

Other identifiers 1

IdentifierTypeStateIssuer
82924767MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823000154 CO Practitioner - Nurse Practitioner 0244364578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

4800 Riverbend Rd
Suite 200
Boulder, CO 80301-2636
Phone (303) 415-8850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3689COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince May 1, 2003 Accepting new patients
Boulder Community Health CurrentSince May 1, 2003 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

4800 Riverbend Rd
Ste 200
Boulder, CO 80301
Phone (303) 415-8850

5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1710960380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-8850",
            "fax_number": "303-415-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 RIVERBEND RD",
            "address_2": "SUITE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012636",
            "telephone_number": "303-415-8850",
            "fax_number": "303-415-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTZMAN",
        "first_name": "ALICIA",
        "middle_name": "E",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0003689-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0003689-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82924767",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.