Boulder Community Health

Organization Active NPI Urgent Care Clinic/Center · Superior, CO

NPI 1730735531 · NPPES record last updated Jul 5, 2022

Key facts

NPI
1730735531
Entity type
Organization (NPI type 2)
Primary specialty
Urgent Care Clinic/Center 261QU0200X
Legal business name
BOULDER COMMUNITY HEALTH
Practice address
3 Superior Dr Ste 100a
Superior, CO 80027-8653
Phone
(303) 415-5255
Fax
(303) 415-5256
NPI assigned
Aug 16, 2019
Organization subpart
Yes
Parent organization (as reported)
BOULDER COMMUNITY HEALTH

Authorized official

Name
William A Munson Jr.
Title
VP,Cfo
Phone
(303) 415-8800

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 33

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

View all 33

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 720

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 720

Medicare Care Compare: Hospital

Listed as
Boulder Community Health CCN 060027
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CO

Hospital certification: CCN 060027

Legal name
BOULDER COMMUNITY HEALTH
Doing business as
BOULDER COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 16, 2024
Beds
181
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Enrollment address
4747 Arapahoe Ave
Boulder, CO 80303-1131
Main/Primary Hospital Location
Hospital subgroups
General

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Perla Delgado
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
Robert Yates
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
Phillip P Distefano
Individual
Corporate Officer
Board Member
Jan 1, 2017
Grant Besser
Individual
Corporate Officer
VP Community Health & Engagement
Oct 17, 2016
W-2 Managing Employee
VP Community Health & Engagement
Oct 17, 2016
Alyssa S Carlson
Individual
Corporate Officer
V.P. and Chief Medical Officer
Nov 2, 2025
W-2 Managing Employee
Ad;MD;
Nov 2, 2025
George Karakehian
Individual
Corporate Officer
Board Member
Jan 1, 2017
Elizabeth Cook
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
Susan Connelly
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2023
Lawrence Novissimo
Individual
Corporate Officer
VP Ambulatory Services
Jul 4, 2021
W-2 Managing Employee
VP Ambulatory Services
Jul 4, 2021
William a Munson
Individual
Corporate Officer
Chief Financial Officer (Cfo) an
Mar 18, 2008
W-2 Managing Employee
Chief Financial Officer (Cfo) an
Mar 16, 2008
Diana Verrilli
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
Jay Pekarek
Individual
W-2 Managing Employee
Delegated Official
Nov 21, 2012
Teresa Cole
Individual
Corporate Officer
VP and Chief Information Officer
Jun 16, 2024
W-2 Managing Employee
VP and Chief Information Officer
Jun 16, 2024
Robert J Vissers
Individual
Corporate Officer
Ceo
Jan 1, 2017
W-2 Managing Employee
Ceo
Jan 1, 2017
John T Greff
Individual
Corporate Officer
Board Member
Jan 1, 2018
Doug Abel
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
Valerie E Lipetz
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
Boulder Community Health
Organization · Boulder, CO
Corporation, Non-profit
Other Jul 1, 1966
Joel R Montbriand
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
John Fleagle
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
Deborah S Lund
Individual
Corporate Officer
Board Member
Jan 1, 2018
Jackie Attlesey-Pries
Individual
Corporate Officer
VP Chief Nursing Officer
Sep 6, 2011
W-2 Managing Employee
VP Chief Nursing Officer
Sep 6, 2011
Chris Hazlitt
Individual
Corporate Officer
Board of Directors Member
Jan 1, 2024
Mardi Moore
Individual
5% Or Greater Direct Ownership Interest
Board Member
Jan 1, 2019
Corporate Officer
Board of Directors Member
Jan 1, 2024
Sarah E Meshak
Individual
Corporate Officer
VP and General Counsel
Aug 31, 2009
W-2 Managing Employee
VP and General Counsel
Aug 31, 2009
Nancy Stevens
Individual
5% Or Greater Direct Ownership Interest
Board Member
Jan 1, 2019
Corporate Officer
Board of Directors Member
Jan 1, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030902000042 CO Part a Provider - Hospital 6800707233 34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20040123000284 CO Part B Supplier - Clinic/Group Practice 6800707233 Receives reassigned benefits from 316 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Erie, CO; Superior, CO; Longmont, CO; Lafayette, CO; Boulder, CO

National Provider Directory

Part of
Michael Vongortler MD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Yes

Addresses

Primary practice location

3 Superior Dr Ste 100a
Superior, CO 80027-8653

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-5255

Other names

  • Community Medical Assoc of B.C.H. Doing business as
  • BCH Urgent Care Superior Other name

Other providers in Superior, CO

All providers in Superior, CO · Urgent Care Clinic/Center in Colorado

Sources for this page

Verify at the official NPI Registry.