Organization Active NPI

Family Practice Associates PC

  • Family Medicine Physician
  • Broomfield, CO
National Provider Identifier
1952593873
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY PRACTICE ASSOCIATES PC
Practice address
433 Summit Blvd Unit 201
Broomfield, CO 80021-8299
Phone
(303) 673-9090
Fax
(303) 673-9195
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Authorized official

Name
Angie Martin
Title
Office Manager
Phone
(303) 673-9090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

433 Summit Blvd Unit 201
Broomfield, CO 80021-8299

Mailing address

433 Summit Blvd Unit 201
Broomfield, CO 80021-8299
Phone (303) 673-9090

Other identifiers 1

IdentifierTypeStateIssuer
49958372MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902001298 CO Part B Supplier - Clinic/Group Practice 7618943432 Receives reassigned benefits from 5 practitioners
Practice locations: Broomfield, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0943685Family Practice Associates, PC433 Summit Blvd, Broomfield, CO 80021Provider-performed microscopyMar 30, 2028

National Provider Directory

National Provider Directory

Locations

433 Summit Blvd
Unit 201
Broomfield, CO 80021
Phone (303) 673-9090

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBHGDD

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1952593873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 SUMMIT BLVD UNIT 201",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218299",
            "telephone_number": "303-673-9090",
            "fax_number": "303-673-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SUMMIT BLVD UNIT 201",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218299",
            "telephone_number": "303-673-9090",
            "fax_number": "303-673-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "303-673-9090"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49958372",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.