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LANDREY FAGAN MD
NPI 1548423817
Family Medicine in Boulder, CO

Active since July 08, 2008PECOS EnrolledAccepts Medicare Assignment
3434 47TH ST STE 225, BOULDER, CO 80301(720) 792-2852(303) 586-7592 Get Directions Write a Review

NPPES record last updated: December 3, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 3, 2024, Sep 24, 2024, Feb 24, 2021 and 1 more (4 updates tracked since 2020).

About Landrey Fagan Md NPPES

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

LANDREY FAGAN MD (NPI 1548423817) is an individual family medicine provider in Boulder, Colorado, licensed in Colorado (DR.0060345) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS, maintains a secondary practice location in Longmont, and is a graduate of Georgetown University School Of Medicine (2008).

NPPES Registry Identity

NPI1548423817
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameLANDREY FAGANCredential: MD
Location Address3434 47TH ST STE 225Boulder, CO 80301-1880
Mailing Address1950 Mountain View AveLongmont, CO 80501-3129 · (303) 651-5111 · Fax (303) 678-4050
Phone(720) 792-2852
Fax(303) 586-7592
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 2008
Enumeration DateJuly 8, 2008
Last NPPES UpdateDecember 3, 20244 updates tracked since enumeration
NPPES CertifiedDecember 3, 2024
✔ NPI 1548423817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in CO · DR.0060345✔ Licensed in CO · DR0060345✔ Licensed in MA · 246674
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 ListedHospitalistTaxonomy 208M00000X · License DR.0060345 (CO)
3434 47TH ST STE 225, Boulder, CO 80301
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Secondary Practice Location 1

Location 11950 Mountain View AveLongmont, CO 80501-3129 · Phone (303) 651-5111 · Fax (303) 678-4050

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Landrey Fagan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537339718
PECOS Enrollment IDI20180905002457
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Landrey Fagan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Four Mile Creek Health
Same address
Family Medicine
3434 47TH ST STE 225
Boulder, CO 80301
  • Reassigned Medicare billing, Colorado enrollment
  • 2 clinicians in this Medicare group
NPI 1225854425 (703) 850-1533
Catholic Health Initiatives Colorado
9.5 mi
Family Medicine
2101 KEN PRATT BLVD STE 200
Longmont, CO 80501
  • Reassigned Medicare billing, Colorado enrollment
  • 1,193 clinicians in this Medicare group
NPI 1780047902 (303) 649-6350

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

FOUR MILE CREEK HEALTH
Family Medicine
3434 47TH ST STE 225
BOULDER, CO 80301
Boulder County (703) 850-1533
FABIANA MONTE ALEGRE OLMOS FERNANDEZ MD
Internal Medicine
3434 47TH ST STE 225
BOULDER, CO 80301
Boulder County (720) 792-2842

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 Landrey Fagan's NPI number?

The NPI number for Landrey Fagan is 1548423817. It was assigned to this individual provider in the NPPES registry on July 8, 2008.

Where is Landrey Fagan located?

Landrey Fagan practices at 3434 47th St Ste 225, Boulder, CO 80301. The listed phone number is (720) 792-2852.

What is Landrey Fagan's specialty?

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

Is Landrey Fagan enrolled in Medicare?

Yes. Landrey Fagan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Landrey Fagan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Landrey Fagan reassigns Medicare benefits to 2 organizations: Four Mile Creek Health (Boulder, CO) and Catholic Health Initiatives Colorado (Longmont, CO). Each 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 Landrey Fagan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Landrey Fagan 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.