Active NPI
Maxime Lepage, DPT
- Physical Therapist
- Boulder, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL.0019199
- Practice address
- 2150 Stadium Drive
Boulder, CO 80309-3107 - Phone
- (303) 315-9900
- Fax
- (303) 315-9902
- NPI assigned
- Aug 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTL.0019199 | CO | Primary |
| Physical Therapist | 225100000X | PT028545 | PA |
Addresses
Primary practice location
2150 Stadium Drive
Boulder, CO 80309-3107
Mailing address
202 Park Blvd Apt 246
Cherry Hill, NJ 08002-3472
Phone (843) 534-6642
Other practice location 1
201 Egg Harbor Rd
Sewell, NJ 08080-3107
Phone (267) 809-1469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2150 Stadium Dr
Boulder, CO 80309-0001
Phone (303) 315-9900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0019199 | CO | MD | Physical Therapist |
| PT028545 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients |
Locations
2150 Stadium Dr
Fl 2
Boulder, CO 80309
Phone (303) 315-9900
2150 Stadium Dr
Boulder, CO 80309
Phone (303) 315-9900
1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Boulder, CO
- NPI 1821074196
-
- Clinic/Center
- Boulder, CO
- NPI 1306493879
-
- Primary Care Clinic/Center
- Boulder, CO
- NPI 1740837137
-
- Medical Specialty Clinic/Center
- Boulder, CO
- NPI 1407685498
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1609822030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720137600000",
"number": "1891305785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 PARK BLVD APT 246",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080023472",
"telephone_number": "843-534-6642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 STADIUM DRIVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803093107",
"telephone_number": "303-315-9900",
"fax_number": "303-315-9902"
}
],
"practiceLocations": [
{
"address_1": "201 Egg Harbor Rd",
"address_purpose": "LOCATION",
"city": "Sewell",
"state": "NJ",
"postal_code": "080803107",
"country_code": "US",
"telephone_number": "267-809-1469",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEPAGE",
"first_name": "MAXIME",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-05",
"last_updated": "2024-07-05",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL.0019199",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT028545",
"primary": false
}
],
"identifiers": [],
"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 Jul 5, 2024; 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.