Organization Active NPI

Boulder Community Health

Doing business as Community Medical Assoc of BCH

  • Primary Care Clinic/Center
  • Boulder, CO
National Provider Identifier
1942856745
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BOULDER COMMUNITY HEALTH
Doing business as
Community Medical Assoc of BCH
Practice address
2575 Spruce St
Boulder, CO 80302-3806
Phone
(303) 415-3875
Fax
(303) 449-3112
NPI assigned
Aug 16, 2019
Last updated
Jul 5, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BOULDER COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
William A Munson Jr.
Title
VP, Cfo
Phone
(303) 415-7433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2575 Spruce St
Boulder, CO 80302-3806

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-3875

Other names 2

  • Community Medical Assoc of BCH Doing business as
  • Spruce Street Internal Medicine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000284 CO Part B Supplier - Clinic/Group Practice 6800707233 Receives reassigned benefits from 316 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Erie, CO; Superior, CO; Longmont, CO; Lafayette, CO; Boulder, CO

National Provider Directory

National Provider Directory
Tax ID family
BCH Physician Clinics83 organizations share this tax ID, including this one
Part of
BCH Physician Clinics

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1942856745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9049",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803019049",
            "telephone_number": "303-415-3875",
            "fax_number": "303-449-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 SPRUCE ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023806",
            "telephone_number": "303-415-3875",
            "fax_number": "303-449-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOULDER COMMUNITY HEALTH",
        "enumeration_date": "2019-08-16",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP, CFO",
        "authorized_official_telephone_number": "303-415-7433",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Assoc of BCH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spruce Street Internal Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Spruce Street Internal Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.