FOUR MILE CREEK HEALTH
NPI 1225854425
Family Medicine in Boulder, CO
About Four Mile Creek Health NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FOUR MILE CREEK HEALTH (NPI 1225854425) is a healthcare organization registered as a family medicine in Boulder, Colorado and active in the NPI registry since December 2024. The organization lists Radford Fagan, Vice President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Four Mile Creek Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Four Mile Creek Health, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Four Mile Creek Health's NPI number?
The NPI number for Four Mile Creek Health is 1225854425. It was assigned to this organization in the NPPES registry on December 3, 2024.
Where is Four Mile Creek Health located?
Four Mile Creek Health is located at 3434 47th St Ste 225, Boulder, CO 80301. The listed phone number is (703) 850-1533.
What is Four Mile Creek Health's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Four Mile Creek Health enrolled in Medicare?
Yes. Four Mile Creek Health is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Four Mile Creek Health?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Four Mile Creek Health, in Hospitalist and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Four Mile Creek Health was last updated on December 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.
# Four Mile Creek Health · NPI 1225854425
Family Medicine organization in Boulder, Colorado. Organization record, active in the CMS NPPES registry since December 3, 2024.
## Identity
- **NPI:** 1225854425 (Entity type: Organization)
- **Enumerated:** December 3, 2024
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Radford Fagan, VICE PRESIDENT
## Practice location
- **Address:** 3434 47TH ST STE 225, Boulder, CO 80301-1880
- **Phone:** (703) 850-1533 · **Fax:** (303) 586-7592
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Hospitalist (1), Internal Medicine (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 3, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1225854425) · Data from the CMS NPPES public registry.