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KOBY CAPLAN MD
NPI 1922568393
Family Medicine in Boulder, CO

Active since March 22, 2019PECOS EnrolledAccepts Medicare Assignment
5495 ARAPAHOE AVE STE 100G, BOULDER, CO 80303(303) 415-4246 Get Directions Write a Review

NPPES record last updated: August 14, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 14, 2024, Mar 22, 2019 (2 updates tracked since 2019).

About Koby Caplan Md NPPES

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

KOBY CAPLAN MD (NPI 1922568393) is an individual family medicine provider in Boulder, Colorado, licensed in Colorado (DR.0073565) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Baylor College Of Medicine (2019).

NPPES Registry Identity

NPI1922568393
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameKOBY CAPLANCredential: MD
Location Address5495 ARAPAHOE AVE STE 100GBoulder, CO 80303-1224
Mailing AddressPo Box 9049Boulder, CO 80301-9049 · (303) 415-4101
Phone(303) 415-4246
Sole ProprietorNo
Medical School CMSBaylor College Of MedicineGraduated 2019
Enumeration DateMarch 22, 2019
Last NPPES UpdateAugust 14, 20242 updates tracked since enumeration
NPPES CertifiedAugust 14, 2024
✔ NPI 1922568393 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CO · DR.0073565
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 ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
5495 ARAPAHOE AVE STE 100G, Boulder, CO 80303
Open in Google Maps ↗

Secondary Practice Locations 2

Location 19228 Medical Plaza DrCharleston, SC 29406-9125 · Phone (843) 876-7080 · Fax (843) 876-7111
Location 22101 Ken Pratt Blvd Ste 104GLongmont, CO 80501-6568 · Phone (303) 415-4246

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

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

Koby Caplan 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 ID9537490461
PECOS Enrollment IDI20240828001780
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 Reassignment

Medicare enrollment records show Koby Caplan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Boulder Community Health
Same address
Primary Care
5495 ARAPAHOE AVE STE 100
Boulder, CO 80303
  • Reassigned Medicare billing, Colorado enrollment
  • 283 clinicians in this Medicare group
NPI 1013564517 (303) 415-4250

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

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
83 services77 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
30 services29 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
13 services13 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80303 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

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

BOULDER COMMUNITY HEALTH
Clinic/Center (Primary Care)
5495 ARAPAHOE AVE STE 100G
BOULDER, CO 80303
Boulder County (303) 415-4246

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 Koby Caplan's NPI number?

The NPI number for Koby Caplan is 1922568393. It was assigned to this individual provider in the NPPES registry on March 22, 2019.

Where is Koby Caplan located?

Koby Caplan practices at 5495 Arapahoe Ave Ste 100G, Boulder, CO 80303. The listed phone number is (303) 415-4246.

What is Koby Caplan's specialty?

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

Is Koby Caplan enrolled in Medicare?

Yes. Koby Caplan 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 organization bills Medicare for Koby Caplan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Koby Caplan reassigns Medicare benefits to Boulder Community Health (Boulder, CO). The 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 Koby Caplan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Koby Caplan accept?

Health plans from Select Health list Koby Caplan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Koby Caplan was last updated on August 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.