LONGS PEAK FAMILY PRACTICE, PC
NPI 1477565380
Family Medicine in Longmont, CO

Active since August 12, 2006CLIA 06D0515817 · Microscopy
1309 SUNSET ST, LONGMONT, CO 80501(303) 772-5578(303) 772-8207 Get Directions Write a Review

NPPES record last updated: February 8, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Longs Peak Family Practice, Pc NPPES

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

LONGS PEAK FAMILY PRACTICE, PC (NPI 1477565380) is a healthcare organization registered as a family medicine in Longmont, Colorado and active in the NPI registry since August 2006. The organization holds a CLIA Microscopy certificate valid through January 28, 2027 and lists Susan I Roach, Officer, as its authorized official.

NPPES Registry Identity

NPI1477565380
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLONGS PEAK FAMILY PRACTICE, PC
Location Address1309 SUNSET STLongmont, CO 80501-3215
Mailing Address1309 Sunset StLongmont, CO 80501-3215 · (303) 772-5578 · Fax (303) 772-8207
Fax(303) 772-8207
Organization SubpartNo
Authorized OfficialSusan I RoachOfficer · (303) 772-5578
Enumeration DateAugust 12, 2006
Last NPPES UpdateFebruary 8, 2008
✔ NPI 1477565380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X
1309 SUNSET ST, Longmont, CO 80501

Other Identifiers 1

Medicare PINCS2608

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 MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Longs Peak Family Practice, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateColoradoEnrollment IDO20040921001319Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Longs Peak Family Practice, PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Family Practice
NPI 1154717676
1309 SUNSET ST
Longmont, CO 80501
(303) 772-5578
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1487068151
1309 SUNSET ST
Longmont, CO 80501
(303) 772-5578
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1689676819
1309 SUNSET ST
Longmont, CO 80501
(303) 772-5578
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1417116146
1309 SUNSET ST
Longmont, CO 80501
(303) 772-5578
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1104141670
1309 SUNSET ST
Longmont, CO 80501
(303) 772-5578
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1013220565
280 EXEMPLA CIR
Lafayette, CO 80026
(303) 338-4545
✔ PECOS✔ Accepts Medicare15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 06D0515817

Longs Peak Family Practice · Longmont, CO
Active · expires Jan 28, 2027
CLIA Number06D0515817
Laboratory TypePhysician Office
Certificate Effective DateJanuary 29, 2025
Certificate Expiration DateJanuary 28, 2027
Laboratory DirectorDr. Rebecca A. Myers
Laboratory Phone(303) 772-5578
Laboratory LocationLongs Peak Family Practice1309 Sunset St, Longmont, CO 80501
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Longs Peak Family Practice, PC's NPI number?

The NPI number for Longs Peak Family Practice, PC is 1477565380. It was assigned to this organization in the NPPES registry on August 12, 2006.

Where is Longs Peak Family Practice, PC located?

Longs Peak Family Practice, PC is located at 1309 Sunset St, Longmont, CO 80501. The listed phone number is (303) 772-5578.

What is Longs Peak Family Practice, PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Longs Peak Family Practice, PC enrolled in Medicare?

Yes. Longs Peak Family Practice, PC is registered in the Medicare PECOS enrollment system.

When is Longs Peak Family Practice, PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Colorado, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Longs Peak Family Practice, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Longs Peak Family Practice, PC. 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. The largest specialties are Family Practice (4) and Nurse Practitioner (2). Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Longs Peak Family Practice, PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 06D0515817) is associated with this NPI, valid through January 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Longs Peak Family Practice, PC was last updated on February 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.