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POTOMAC SQUARE FAMILY MEDICINE, LLC
NPI 1861001554
Clinic/Center - Primary Care in Boulder, CO

Active since July 28, 2020
4800 BASELINE RD STE D106, BOULDER, CO 80303(303) 499-0176 Get Directions Write a Review

NPPES record last updated: April 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 14, 2022, Sep 15, 2020, Jul 28, 2020 (3 updates tracked since 2020).

About Potomac Square Family Medicine, Llc NPPES

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

POTOMAC SQUARE FAMILY MEDICINE, LLC (NPI 1861001554) is a healthcare organization registered as a primary care in Boulder, Colorado and active in the NPI registry since July 2020. The organization lists Stephanie Gluchacki, Svp, Compliance, as its authorized official.

NPPES Registry Identity

NPI1861001554
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePOTOMAC SQUARE FAMILY MEDICINE, LLC
Location Address4800 BASELINE RD STE D106Boulder, CO 80303-2643
Mailing AddressPo Box 173848Denver, CO 80217-3848 · (303) 945-3299 · Fax (303) 945-3303
Phone(303) 499-0176
Organization SubpartNo
Authorized OfficialStephanie GluchackiSvp, Compliance · (508) 689-9706
Enumeration DateJuly 28, 2020
Last NPPES UpdateApril 14, 20223 updates tracked since enumeration
NPPES CertifiedApril 14, 2022
✔ NPI 1861001554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedPhysical TherapistTaxonomy 225100000X
4800 BASELINE RD STE D106, Boulder, CO 80303
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Other Identifiers 1

Medicaid18903312CO

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

Other Providers at the Same Location NPPES 3

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

ROCKY MOUNTAIN MEDICAL GROUP, P.C.
Preventive Medicine (Occupational Medicine)
4800 BASELINE RD STE D106
BOULDER, CO 80303
Boulder County (303) 499-4800
CARISSA REANNA MARTINEZ FNP
Nurse Practitioner
4800 BASELINE RD STE D106
BOULDER, CO 80303
Boulder County (303) 499-4800
ROCKY MOUNTAIN URGENT CARE, LLC
Clinic/Center (Urgent Care)
4800 BASELINE RD STE D106
BOULDER, CO 80303
Boulder County (303) 499-4800

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 Potomac Square Family Medicine, LLC's NPI number?

The NPI number for Potomac Square Family Medicine, LLC is 1861001554. It was assigned to this organization in the NPPES registry on July 28, 2020.

Where is Potomac Square Family Medicine, LLC located?

Potomac Square Family Medicine, LLC is located at 4800 Baseline Rd Ste D106, Boulder, CO 80303. The listed phone number is (303) 499-0176.

What is Potomac Square Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Potomac Square Family Medicine, LLC was last updated on April 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.