Active NPI
Leon Tan Que Jr., MD
- Psychiatry Physician
- Boulder, CO
National Provider Identifier
1801873740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- DR-49828
- 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, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M67254 | Other | MD | DIVISION OF DRUG CONTROL |
| D68063 | Other | MD | BOARD OF PHYSICIANS |
| DR-49828 | Other | CO | LICENSE |
| A83944 | Other | CA | MEDICAL 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
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| DR-49828 | CO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Specialist
- Boulder, CO
- NPI 1134307606
-
- Psychiatry Physician
- Boulder, CO
- NPI 1598061699
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.