Optimindhealth | |
4770 Baseline Rd Ste 200 Boulder CO 80303-2668 | |
(720) 893-0842 | |
Not Available |
Full Name | Optimindhealth |
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Speciality | Clinic/Center |
Location | 4770 Baseline Rd Ste 200, Boulder, Colorado |
Authorized Official Name and Position | Joseph Yeretsian (PRESIDENT) |
Authorized Official Contact | 6175071472 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Optimindhealth 4770 Baseline Rd 2nd Floor Boulder CO 80303-2666 Ph: (720) 893-0842 | Optimindhealth 4770 Baseline Rd Ste 200 Boulder CO 80303-2668 Ph: (720) 893-0842 |
NPI Number | 1942668165 |
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Provider Enumeration Date | 02/02/2016 |
Last Update Date | 01/02/2020 |
Certification Date | 01/02/2020 |
Medicare PECOS PAC ID | 5597893313 |
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Medicare Enrollment ID | O20200318000673 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942668165 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | DR.0056212 (Colorado) | Primary |
Provider Name | Joseph Yeretsian |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1003070210 PECOS PAC ID: 6002944824 Enrollment ID: I20200318000785 |
Provider Name | Sarah Schumacher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336687060 PECOS PAC ID: 4183054331 Enrollment ID: I20200430002393 |
Provider Name | Shanin Rae Vowell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306434857 PECOS PAC ID: 0042628398 Enrollment ID: I20210426002495 |
Provider Name | Christopher Jesus Mercado |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457957532 PECOS PAC ID: 0749680585 Enrollment ID: I20210615003107 |
Provider Name | Alex Joshua Betz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952905929 PECOS PAC ID: 0244634624 Enrollment ID: I20210806001380 |
Provider Name | Jaimee Lyn Brielmaier |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790429629 PECOS PAC ID: 2668848359 Enrollment ID: I20221020002727 |
Provider Name | Alyssa Gosselin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427775980 PECOS PAC ID: 3375915945 Enrollment ID: I20230207003547 |
Provider Name | Julie Marie Bass |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083167019 PECOS PAC ID: 0941673388 Enrollment ID: I20230306000388 |
Provider Name | Rebekah Bullock |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285168344 PECOS PAC ID: 2567730153 Enrollment ID: I20230320000569 |
Provider Name | Melody Bourret |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548926488 PECOS PAC ID: 1850753914 Enrollment ID: I20230822000901 |
Provider Name | Kelsey Nicole Froom |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487388435 PECOS PAC ID: 1557738804 Enrollment ID: I20231211001943 |
Provider Name | Rebecca E Robitaille |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154194199 PECOS PAC ID: 2365885191 Enrollment ID: I20240208003855 |
Provider Name | Reid Hoffman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922875566 PECOS PAC ID: 5597106286 Enrollment ID: I20240513001709 |
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