Individual provider Active NPI

Stephanie Holst

  • Occupational Therapist
  • Broomfield, CO
National Provider Identifier
1992109029
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT.0004103 Issued in CO
Practice address
500 W 144TH Ave Ste 230
Broomfield, CO 80023-9328
Phone
(303) 665-2603
Fax
(303) 665-2605
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Physical Therapist 2251H1200X
Occupational Therapist 225X00000X OT.0004103 CO Primary

Addresses

Primary practice location

500 W 144TH Ave Ste 230
Broomfield, CO 80023-9328

Mailing address

514 Deer Run LN
Papillion, NE 68046-4331
Phone (402) 547-0790

Other practice location 1

514 Deer Run Ln
Papillion, NE 68046-4331
Phone (402) 547-0790

Other practice location 2

3455 N Lutheran Pkwy
Wheat Ridge, CO 80033
Phone (303) 456-6000

Other names 1

  • Mrs. Stephanie Broderick Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200501001479 CO Practitioner - Occupational Therapist in Private Practice 4183054372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12905 W 40TH Ave
Suite 520
Golden, CO 80401-2790
Phone (303) 665-2603

1411 S Potomac St
350 Coc Arapahoe Sports Medicine and Rehab
Aurora, CO 80012-4543
Phone (303) 695-6060

3 Superior Dr
Suite 225
Superior, CO 80027-8661
Phone (303) 665-2603

Merit-based Incentive Payment System (MIPS)

Final score
43.24 of 100Reported as group
Quality
73.53
Promoting interoperability
0
Improvement activities
0
Cost
70.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT.0004103COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Centers of Colorado, LLC Occupational Therapist CurrentSince Mar 1, 2020 Accepting new patients
Orthopedic Centers of Colorado, LLC Occupational Therapist CurrentSince Mar 1, 2020 Accepting new patients

Locations

1411 S Potomac St
Ste 350
Aurora, CO 80012
Phone (303) 671-2134

8101 E Lowry Blvd
Ste 120
Lowry, CO 80230
Phone (303) 806-1998

3 Superior Dr
Ste 225
Superior, CO 80027
Phone 3036652603106

500 W 144th Ave
Ste 230
Westminster, CO 80023
Phone 3036652603 ext. 223

3455 Lutheran Pkwy
Ste 105
Wheat Ridge, CO 80033
Phone (303) 456-6000

3455 Lutheran Pkwy
Wheat Ridge, CO 80033
Phone (303) 301-7700

Organizations & group practices 2

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": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1992109029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 DEER RUN LN",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464331",
            "telephone_number": "402-547-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 144TH AVE STE 230",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239328",
            "telephone_number": "303-665-2603",
            "fax_number": "303-665-2605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 Deer Run Ln",
            "address_purpose": "LOCATION",
            "city": "Papillion",
            "state": "NE",
            "postal_code": "680464331",
            "country_code": "US",
            "telephone_number": "402-547-0790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3455 N Lutheran Pkwy",
            "address_purpose": "LOCATION",
            "city": "Wheat Ridge",
            "state": "CO",
            "postal_code": "80033",
            "country_code": "US",
            "telephone_number": "303-456-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLST",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT.0004103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "BRODERICK",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jun 17, 2019; 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.