Alyssa Quam

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0020508 Issued in CO

Practice address

3434 47TH St Ste 107
Boulder, CO 80301-1817

Phone

(303) 376-0184

NPI assigned

Sep 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Water and Sports Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • San Diego, CA
  • NPI 1588085625
  NPD (past)

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1801299276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 47TH ST STE 107",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 47TH ST STE 107",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011817",
            "telephone_number": "303-376-0184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2999 Mission Blvd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921098028",
            "country_code": "US",
            "telephone_number": "858-488-3597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUAM",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "91661",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0020508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Qi, D.M.D.
• Kevin Scott Quackenbush, MD
• Jamie Victoria Quail, MA, LPC
• Quality Urgent Care Professional Corporation
• Quality Urgent Care Professional Corporation
• Vicki L Quarles, LCSW
• Colette Quattrone
• Leon Tan Que Jr., MD
• Queer Asterisk
• Mary Quesenberry

• All providers in Boulder, CO
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.