Individual provider Active NPI

Guillaume Fouque, P.T.

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1891810073
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4574 Issued in CO
Practice address
4740 Pearl Pkwy Ste 200
Boulder, CO 80301-3080
Phone
(303) 449-2730
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4574 CO Primary

Addresses

Primary practice location

4740 Pearl Pkwy Ste 200
Boulder, CO 80301-3080

Mailing address

Dept. 1244
Denver, CO 80291-1244
Phone (303) 486-5504

Other practice location 1

317 W South Boulder Rd
Louisville, CO 80027-1289
Phone (303) 673-1240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200529000835 CO Practitioner - Physical Therapist in Private Practice 9931338050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bouldercentre for Orthopedics PCGroup PAC ID 3971409020, 56 clinicians

Practice addresses (Care Compare)

4740 Pearl Pkwy
Suite 200
Boulder, CO 80301-3080
Phone (303) 449-2730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4574COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bouldercentre for Orthopedics PC CurrentSince Aug 6, 2022 Accepting new patients
Bouldercentre for Orthopedics Physical Therapist Past Accepting new patients
Bouldercentre for Orthopedics PastSince Feb 11, 2024 Accepting new patients
Registered Physical Therapy Associates, PC Physical Therapist Past Accepting new patients

Locations

4740 Pearl Pkwy
Ste 300
Boulder, CO 80301
Phone (303) 442-2666

4740 Pearl Pkwy
Ste 200
Boulder, CO 80301

1185 State Highway 7
Ste 200
Broomfield, CO 80023

Interoperability endpoints

  • Direct secure messaging: gui.fouque.1@3497.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3497/brand/1/csg/21/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1891810073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. 1244",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911244",
            "telephone_number": "303-486-5504",
            "fax_number": "303-486-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 PEARL PKWY STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013080",
            "telephone_number": "303-449-2730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 W South Boulder Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800271289",
            "country_code": "US",
            "telephone_number": "303-673-1240",
            "fax_number": "303-673-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOUQUE",
        "first_name": "GUILLAUME",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "4574",
            "primary": true
        }
    ],
    "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 Oct 3, 2023; 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.

Verify at the official NPI Registry.