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MIDVALLEY FAMILY PRACTICE PC
NPI 1568559748
Family Medicine in Basalt, CO

Active since October 06, 2006CLIA 06D1080809 · Certificate of Compliance
1450 E VALLEY RD, SUITE 102, BASALT, CO 81621(970) 927-4666(970) 927-6623 Get Directions Write a Review

NPPES record last updated: July 7, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Midvalley Family Practice Pc NPPES

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

MIDVALLEY FAMILY PRACTICE PC (NPI 1568559748) is a healthcare organization registered as a family medicine in Basalt, Colorado and active in the NPI registry since October 2006. The organization holds a CLIA Certificate of Compliance certificate valid through September 30, 2027 and lists Heather Boronski, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1568559748
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMIDVALLEY FAMILY PRACTICE PC
Location Address1450 E VALLEY RD, SUITE 102Basalt, CO 81621
Mailing Address1450 E Valley Rd, Suite 102Basalt, CO 81621 · (970) 927-4666 · Fax (970) 927-6623
Phone(970) 927-4666
Fax(970) 927-6623
Organization SubpartNo
Authorized OfficialHeather BoronskiOffice Manager · (970) 927-4666
Enumeration DateOctober 6, 2006
Last NPPES UpdateJuly 7, 2020
NPPES CertifiedJuly 7, 2020
✔ NPI 1568559748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CO · 30756
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 ListedDental HygienistTaxonomy 124Q00000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
1450 E VALLEY RD, Basalt, CO 81621
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Other Identifiers 1

Medicaid04826027CO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Midvalley Family Practice PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Andrew Brooks, DO
Family Practice
NPI 1982285649
1450 E VALLEY RD UNIT 102
Basalt, CO 81621
(970) 927-4666
✔ PECOS✔ Accepts MedicareSame address
Glenn Kotz, MD
Family Practice
NPI 1417943366
1450 E VALLEY RD SUITE 101
Basalt, CO 81621
(970) 927-6101
✔ PECOS✔ Accepts MedicareSame address
Jarid Rollins, LCSW
Clinical Social Worker
NPI 1518361070
1450 E VALLEY RD UNIT 102
Basalt, CO 81621
(970) 920-5555
✔ PECOS✔ Accepts MedicareSame address
Jennifer Copeland, M.D.
Family Practice
NPI 1679591051
603 28 1/4 RD
Grand Junction, CO 81506
(970) 263-2600
✔ PECOS✔ Accepts Medicare80 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 of Compliance 06D1080809

Midvalley Family Practice · Basalt, CO
Active · expires Sep 30, 2027
CLIA Number06D1080809
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorGlenn E. Kotz
Laboratory Phone(970) 927-4666
Laboratory LocationMidvalley Family Practice1450 E Valley Road #102, Basalt, CO 81621
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Midvalley Family Practice PC's NPI number?

The NPI number for Midvalley Family Practice PC is 1568559748. It was assigned to this organization in the NPPES registry on October 6, 2006.

Where is Midvalley Family Practice PC located?

Midvalley Family Practice PC is located at 1450 E Valley Rd Suite 102, Basalt, CO 81621. The listed phone number is (970) 927-4666.

What is Midvalley Family Practice PC's specialty?

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

Is Midvalley Family Practice PC enrolled in Medicare?

Yes. Midvalley Family Practice PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Midvalley Family Practice PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Midvalley 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 (3) and Clinical Social Worker (1). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Midvalley Family Practice PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 06D1080809) is associated with this NPI, valid through September 30, 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 Midvalley Family Practice PC was last updated on July 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.