NPIMap

Individual provider Active NPI

Andrew C Goldman, M.D.

  • Otolaryngology Physician
  • Boulder, CO
National Provider Identifier
1891713152
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
42935 Issued in CO
Practice address
4745 Arapahoe Ave
Suite 130
Boulder, CO 80303-1080
Phone
(303) 443-2771
Fax
(303) 443-2784
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

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
Otolaryngology Physician 207Y00000X 42935 CO Primary

Addresses

Primary practice location

4745 Arapahoe Ave
Suite 130
Boulder, CO 80303-1080

Mailing address

4745 Arapahoe Ave
Suite 130
Boulder, CO 80303-1080
Phone (303) 443-2771

Other identifiers 1

IdentifierTypeStateIssuer
42935OtherCOCOLORADO STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090504000082 CO Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 5698823573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Valley Ear Nose and Throat Associates PCGroup PAC ID 9234128216, 15 clinicians

Practice addresses (Care Compare)

4745 Arapahoe Ave
Suite 130
Boulder, CO 80303-1082
Phone (303) 443-2771

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42935COMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Valley Ear Nose & Throat Associates PC Otolaryngology CurrentSince Nov 16, 2008 Accepting new patients
Long Island College Hospital Past Accepting new patients
Hanger Prosthetics & Orthotics West Inc. Past Accepting new patients
Lich Faculty Practice Past Accepting new patients

Locations

4745 Arapahoe Ave
Ste 130
Boulder, CO 80303
Phone (303) 443-2771

300 Exempla Cir
Ste 210
Lafayette, CO 80026
Phone (303) 443-2771

300 Exempla Cir
Ste 270
Lafayette, CO 80026
Phone (303) 443-2771

588 N US Highway 287
Ste 204
Lafayette, CO 80026
Phone (303) 443-2771

90 Health Park Dr
Ste 220
Louisville, CO 80027
Phone (303) 443-2771

Organizations & group practices 4

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.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1891713152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE",
            "address_2": "SUITE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031080",
            "telephone_number": "303-443-2771",
            "fax_number": "303-443-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE",
            "address_2": "SUITE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031080",
            "telephone_number": "303-443-2771",
            "fax_number": "303-443-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "ANDREW",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "42935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO STATE LICENSE",
            "identifier": "42935",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.