Active NPI
Boulder Medical Center, PC
- Ambulatory Surgical Clinic/Center
- Boulder, CO
National Provider Identifier
1962668319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- 160365
- Legal business name
- BOULDER MEDICAL CENTER, PC
- Practice address
- 2750 Broadway St
Boulder, CO 80304-3573 - Phone
- (303) 440-3000
- NPI assigned
- Aug 5, 2008
- Last updated
- Apr 29, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Casandra Richards
- Title
- Credentialing Coordinator
- Phone
- (303) 440-3076
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 160365 | CO | Primary |
Addresses
Primary practice location
2750 Broadway St
Boulder, CO 80304-3573
Mailing address
2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160365 | Other | CO | STATE LICENSE AS AMBULATORY SURGICAL CENTER |
Other names 1
- Boulder Medical Center ASC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040322000839 | CO | Part B Supplier - Ambulatory Surgical Center | 4183536204 | Practice locations: Boulder, CO |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Boulder Medical Center PC
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Boulder Medical Center PC
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urgent Care Clinic/Center
- Boulder, CO
- NPI 1114886587
-
- Multi-Specialty Clinic/Center
- Longmont, CO
- NPI 1144853904
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1174156939
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Emergency Medicine Physician
- Boulder, CO
- NPI 1982681854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217894400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777420800000",
"number": "1962668319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2750 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043573",
"telephone_number": "303-440-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043573",
"telephone_number": "303-440-3000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BOULDER MEDICAL CENTER, PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-05",
"last_updated": "2026-04-29",
"certification_date": "2026-04-29",
"status": "A",
"authorized_official_last_name": "RICHARDS",
"authorized_official_first_name": "CASANDRA",
"authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
"authorized_official_telephone_number": "303-440-3076"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "CO",
"license": "160365",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE AS AMBULATORY SURGICAL CENTER",
"identifier": "160365",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Boulder Medical Center ASC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Boulder, CO
- Boulder Management Services Organization (The Thayer Group for Womens Care)
- Boulder Massage (Boulder Massage & NeuroMuscular Therapy)
- Boulder Medical Center, P.C.
- Boulder Medical Center, P.C.
- Boulder Medical Center, P.C.
- Boulder Mental Health Center
- Boulder Mobile Acute Care PC
- Boulder Modern Dentistry, LLP (Boulder Modern Dentistry)
- Boulder Natural Medicine Clinic
- Boulder Neuropsychological Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.