Individual provider Active NPI

Leon Tan Que Jr., MD

  • Psychiatry Physician
  • Boulder, CO
National Provider Identifier
1801873740
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DR-49828 Issued in CO
Practice address
3445 Penrose PL
Suite 130
Boulder, CO 80301-1878
Phone
(303) 442-2288
Fax
(303) 444-5551
NPI assigned
Dec 30, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR-49828 CO Primary

Addresses

Primary practice location

3445 Penrose PL
Suite 130
Boulder, CO 80301-1878

Mailing address

3445 Penrose PL
Suite 130
Boulder, CO 80301-1878
Phone (303) 442-2288

Other identifiers 4

IdentifierTypeStateIssuer
M67254OtherMDDIVISION OF DRUG CONTROL
D68063OtherMDBOARD OF PHYSICIANS
DR-49828OtherCOLICENSE
A83944OtherCAMEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Previously, effective Aug 26, 2014 through Aug 26, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR-49828COMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frank Guerra MD PC Past Accepting new patients
GF Institute, PLLC Psychiatry Past Accepting new patients

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1801873740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 PENROSE PL",
            "address_2": "SUITE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011878",
            "telephone_number": "303-442-2288",
            "fax_number": "303-444-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 PENROSE PL",
            "address_2": "SUITE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011878",
            "telephone_number": "303-442-2288",
            "fax_number": "303-444-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUE",
        "first_name": "LEON",
        "middle_name": "TAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR-49828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF DRUG CONTROL",
            "identifier": "M67254",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHYSICIANS",
            "identifier": "D68063",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DR-49828",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD",
            "identifier": "A83944",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.