Individual provider Active NPI

Mitzi L Harrison, PHYSICAL THERAPIST

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1790772630
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13219 Issued in CO
Practice address
2299 Pearl St Ste 300
Boulder, CO 80302-4673
Phone
(720) 845-0001
Fax
(720) 204-1748
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Physical Therapist 2251H1200X 13219 CO
Physical Therapist 225100000X 13219 CO Primary

Addresses

Primary practice location

2299 Pearl St Ste 300
Boulder, CO 80302-4673

Mailing address

2299 Pearl St Ste 300
Boulder, CO 80302-4673
Phone (720) 845-0001

Other identifiers 3

IdentifierTypeStateIssuer
PTL.0013219OtherCOPHYSICAL THERAPY LICENSE
9000173432MedicaidCO
PT15363OtherCAPHYSICAL THERAPY LICENSE

Other names 1

  • Mitzi L Rodriguez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061208000504 CA Practitioner - Physical Therapist in Private Practice 9537159215 Reassigns benefits to 1 organization
I20150625001974 CO Practitioner - Physical Therapist in Private Practice 9537159215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Certified Hand Therapy Services LLCGroup PAC ID 8426394107, 3 clinicians

Practice addresses (Care Compare)

2299 Pearl St
Suite 200
Boulder, CO 80302-4670
Phone (720) 845-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13219COMDPhysical Therapy Assistant
15363CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Basil R Besh MD Inc CurrentSince May 10, 2018 Accepting new patients
Certified Hand Therapy Services LLC Physical Therapist CurrentSince Nov 15, 2018 Accepting new patients
Premier Rehabilitation, Inc. Physical Therapist PastSince May 2, 2002 Accepting new patients

Locations

39180 Farwell Dr
Ste 231
Fremont, CA 94538
Phone (510) 585-2545

39180 Farwell Dr
Ste 211
Fremont, CA 94538
Phone (510) 857-1000

2299 Pearl St
Ste 300
Boulder, CO 80302

2299 Pearl St
Ste 211
Boulder, CO 80302
Phone (720) 845-0001

2299 Pearl St
Ste 200
Boulder, CO 80302
Phone (720) 845-0001

1800 30th St
Ste 206
Boulder, CO 80301
Phone (720) 724-0998

Organizations & group practices 3

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1790772630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 PEARL ST STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024673",
            "telephone_number": "720-845-0001",
            "fax_number": "720-204-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 PEARL ST STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024673",
            "telephone_number": "720-845-0001",
            "fax_number": "720-204-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MITZI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "CO",
            "license": "13219",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "13219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PTL.0013219",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000173432",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT15363",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MITZI",
            "last_name": "RODRIGUEZ",
            "middle_name": "L",
            "credential": "PHYSICAL THERAPIST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.