CARL A MORTIZ JR MBR
NPI 1164048161
Family Medicine in Boulder, CO
NPI Status: Active since June 25, 2020
Contact Information
2760 29TH ST STE 2B
BOULDER, CO
ZIP 80301
Phone: (303) 444-6400
Fax: (303) 444-6465
- Organization
- Family Medicine
- CLIA Number: 06D0514918
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-17-2028
About CARL A MORTIZ JR MBR
This page provides the complete NPI Profile along with additional information for Carl A Mortiz Jr Mbr, a primary care provider established in Boulder, Colorado operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1164048161 assigned on June 2020. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's other name is Carl A Mortiz Jr Mbr. The authorized official of this NPI record is Ms. Lauren Jasilli Fnp-c (Practice Owner)
- NPI
- 1164048161
- Provider Legal Name
- CROSSROADS MEDICAL CENTER
- Other Organization Name
- CARL A MORTIZ JR MBR
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 2760 29TH ST STE 2B BOULDER, CO 80301
- Location Phone
- (303) 444-6400
- Location Fax
- (303) 444-6465
- Mailing Address
- 2760 29TH ST STE 2B BOULDER, CO 80301
- Mailing Phone
- (303) 444-6400
- Mailing Fax
- (303) 444-6465
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-25-2020
- Last Update Date
- 09-27-2024
- Code Navigator
A primary care provider (PCP) like Carl A Mortiz Jr Mbr sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0126399 | MEDICAID (05) | CO |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 06D0514918
- Facility Type
- Physician Office
- Certificate Effective Date
- January 18, 2026
- Certificate Expiration Date
- January 17, 2028
- Laboratory Director
- CARL A. MORITZ
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Carl A Mortiz Jr Mbr to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1164048161, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 49 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164048161, enumerated as an "organization" on June 25, 2020.
The provider is located at 2760 29TH ST STE 2B BOULDER, CO 80301 and the phone number is (303) 444-6400.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
