Boulder Plastic Surgery Prof LLC
NPI 1114513009ActiveOrganization· Specialist· Longmont, CO
Specialist in Longmont, Colorado, registered in NPPES in December 2020. The authorized official on file is Pam Garcia, Office Contact.
Overview
| NPI | 1114513009 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 15, 2020 |
| Last updated in NPPES | Dec 15, 2020 |
| Certified by provider | Dec 15, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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