Individual provider Active NPI

Robert Adams, PT, DPT

  • Physical Therapist
  • Broomfield, CO
National Provider Identifier
1740829779
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0016750 Issued in CO
Practice address
13606 Xavier LN
Broomfield, CO 80023-3604
Phone
(303) 404-9494
NPI assigned
Dec 20, 2019
Last updated
Dec 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0016750 CO Primary

Addresses

Primary practice location

13606 Xavier LN
Broomfield, CO 80023-3604

Mailing address

4901 W 93Rd Ave Apt 2324
Westminster, CO 80031-6336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200217004603 CO Practitioner - Physical Therapist in Private Practice 9133556970 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0016750COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy of Boulder Physical Therapist CurrentSince Feb 22, 2021 Accepting new patients
Mend PLLC Physical Therapist CurrentSince Apr 3, 2023 Accepting new patients

Locations

2760 29th St
Ste 1B
Boulder, CO 80301
Phone (720) 772-6780

3020 Carbon Pl
Ste 330
Boulder, CO 80301
Phone (303) 938-1141

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": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1740829779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 W 93RD AVE APT 2324",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800316336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13606 XAVIER LN",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800233604",
            "telephone_number": "303-404-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "ROBERT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0016750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.