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BOULDER PLASTIC SURGERY PROF LLC
NPI 1043251432
Specialist in Boulder, CO

Active since June 09, 2006
1215 SPRUCE ST STE 201, BOULDER, CO 80302(303) 443-2277(303) 443-7124 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 2, 2025, Feb 1, 2021, Dec 15, 2020 (3 updates tracked since 2020).

About Boulder Plastic Surgery Prof Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOULDER PLASTIC SURGERY PROF LLC (NPI 1043251432) is a healthcare organization registered as a specialist in Boulder, Colorado and active in the NPI registry since June 2006. The organization lists Bethany Mason, Insurance Billing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1043251432
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBOULDER PLASTIC SURGERY PROF LLC
Location Address1215 SPRUCE ST STE 201Boulder, CO 80302-4839
Mailing Address1215 Spruce St Ste 201Boulder, CO 80302-4839 · (303) 443-2277 · Fax (303) 443-7124
Phone(303) 443-2277
Fax(303) 443-7124
Organization SubpartNo
Authorized OfficialBethany MasonInsurance Billing Coordinator · (303) 558-5407
Enumeration DateJune 9, 2006
Last NPPES UpdateDecember 2, 20253 updates tracked since enumeration
NPPES CertifiedDecember 2, 2025
✔ NPI 1043251432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1215 SPRUCE ST STE 201, Boulder, CO 80302
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Other Identifiers 1

OtherDD7824CO · Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RONALD WINFIELD HARTLEY JR. MD
Surgery (Plastic and Reconstructive Surgery)
1215 SPRUCE ST STE 201
BOULDER, CO 80302
Boulder County (303) 443-2277
DR. JUSTIN BRIAN MAXHIMER M.D.
Plastic Surgery
1215 SPRUCE ST STE 201
BOULDER, CO 80302
Boulder County (303) 443-2277
JOSHUA DALE ROUCH M.D.
Surgery (Plastic and Reconstructive Surgery)
1215 SPRUCE ST STE 201
BOULDER, CO 80302
Boulder County (303) 443-2277

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boulder Plastic Surgery Prof LLC's NPI number?

The NPI number for Boulder Plastic Surgery Prof LLC is 1043251432. It was assigned to this organization in the NPPES registry on June 9, 2006.

Where is Boulder Plastic Surgery Prof LLC located?

Boulder Plastic Surgery Prof LLC is located at 1215 Spruce St Ste 201, Boulder, CO 80302. The listed phone number is (303) 443-2277.

What is Boulder Plastic Surgery Prof LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Boulder Plastic Surgery Prof LLC was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.