Individual provider Active NPI

Martina Elizabeth Hauptmann, PT

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1952554875
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10179 Issued in CO
Practice address
3000 Center Green Dr Ste 110
Boulder, CO 80301-2364
Phone
(303) 413-9903
Fax
(303) 447-3390
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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 10179 CO Primary

Addresses

Primary practice location

3000 Center Green Dr Ste 110
Boulder, CO 80301-2364

Mailing address

295 Broken Fence Rd
Boulder, CO 80302-9607
Phone (303) 601-6666

Other identifiers 1

IdentifierTypeStateIssuer
10179OtherCOPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081217000342 CO Practitioner - Physical Therapist in Private Practice 3476615972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Wayne State University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roaming Rehab LLCGroup PAC ID 4082015235, 21 clinicians

Practice addresses (Care Compare)

Lakewood, CO 80232
Phone (716) 444-7751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10179COMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1952554875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 BROKEN FENCE RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803029607",
            "telephone_number": "303-601-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CENTER GREEN DR STE 110",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012364",
            "telephone_number": "303-413-9903",
            "fax_number": "303-447-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUPTMANN",
        "first_name": "MARTINA",
        "middle_name": "ELIZABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "10179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "10179",
            "state": "CO"
        }
    ],
    "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 23, 2008; 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.