Ethan Bridge

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0009608 Issued in CO

Practice address

1140 W South Boulder Rd Ste 202
Lafayette, CO 80026-8910

Phone

(303) 604-1444

NPI assigned

Jan 12, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2831/brand/1/csg/1/fhir/r4

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.

• Boulder Valley Center for Dermatology LLC

  • Dermatology Physician
  • Lafayette, CO
  • NPI 1306927231
  Medicare reassignment NPD
• Boulder Valley Center for Dermatology LLC

  • Dermatology Physician
  • Boulder, CO
  • NPI 1063018000
  NPD (past)

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1982562724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W SOUTH BOULDER RD STE 202",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W SOUTH BOULDER RD STE 202",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268910",
            "telephone_number": "303-604-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGE",
        "first_name": "ETHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Breidenstein, MSW
• Aaron Brewer
• Jaime Brewer, MA, LPC, LMHC, CCI
• Brian C. Leypoldt, DDS, MSD, PLLC
• Debra L Bridge
• Bright Life Counseling
• Bright Path Therapy LLC
• Brightly Dental Lafayette
• Brighton Community Hospital Association
• Marika Brimeyer, RN

• Physician Assistant in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.