NPIMap

Individual provider Active NPI

Jose Edmundo Manrique Mercado, MD

  • Family Medicine Physician
  • Boulder, CO
National Provider Identifier
1962709246
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0050935 Issued in CO
Practice address
4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone
(303) 415-7610
Fax
(303) 415-7618
NPI assigned
Feb 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0050935 CO Primary

Addresses

Primary practice location

4747 Arapahoe Ave
Boulder, CO 80303-1131

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-8940

Other practice location 1

11278 Colony Cir
Broomfield, CO 80021-4105
Phone (303) 884-7490

Other practice location 2

3 Superior Dr Ste 100B
Superior, CO 80027-8653
Phone (303) 415-8940

Other identifiers 1

IdentifierTypeStateIssuer
90120078MedicaidCO

Other names 1

  • Edmundo Manrique Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131017000438 CO Practitioner - Family Practice 6002058237 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7160

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027
  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Services, PC Family Medicine Current Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Boulder Community Health CurrentSince Jul 1, 2016 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Dec 18, 2015 Accepting new patients
Boulder Community Health CurrentSince Jul 1, 2016 Accepting new patients
Firstdoc PC CurrentSince Jan 10, 2024 Accepting new patients
Inpatient Services, PC Family Medicine CurrentSince Nov 1, 2015 Accepting new patients
Colorado Hospitalist Services, PLLC Hospitalist CurrentSince Jan 1, 2016 Accepting new patients
Boulder Community Health Current Accepting new patients
Inpatient Services, PC Family Medicine CurrentSince Nov 1, 2015 Accepting new patients
Colorado Hospitalist Services, PLLC Hospitalist CurrentSince Jan 1, 2016 Accepting new patients
Longmont Pulmonary and Critical Care Associates, PC Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1690 Meade St
Denver, CO 80204
Phone (303) 264-6900

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

5881 W 16th St
Greeley, CO 80634
Phone (970) 313-2700

2030 Mountain View Ave
Ste 250
Longmont, CO 80501
Phone (303) 485-4243

2030 Mountain View Ave
Ste 540
Longmont, CO 80501
Phone (303) 651-5302

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

3 Superior Dr
Ste 100B
Superior, CO 80027
Phone (303) 415-8940

6500 W 104th Ave
Westminster, CO 80020
Phone (720) 573-5000

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 61

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1962709246",
    "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": "303-415-8940",
            "fax_number": "303-425-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 ARAPAHOE AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031131",
            "telephone_number": "303-415-7610",
            "fax_number": "303-415-7618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11278 Colony Cir",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800214105",
            "country_code": "US",
            "telephone_number": "303-884-7490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Superior Dr Ste 100B",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "CO",
            "postal_code": "800278653",
            "country_code": "US",
            "telephone_number": "303-415-8940",
            "fax_number": "303-425-9259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANRIQUE MERCADO",
        "first_name": "JOSE",
        "middle_name": "EDMUNDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0050935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90120078",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDMUNDO",
            "last_name": "MANRIQUE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.