MYRA BETH TUCKERMAN MD NPI 1831184381

NPI Information

  • NPI: 1831184381
  • Provider Name: MYRA BETH TUCKERMAN, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1790 30TH ST
    SUITE 308
    BOULDER, CO
    ZIP 80301
  • Phone: (303) 440-0205

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NPI Details

Myra Beth Tuckerman, MD is a family medicine in Boulder, CO. The provider is 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. Myra Beth Tuckerman, MD NPI is 1831184381. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1790 30TH ST
SUITE 308
BOULDER, CO
ZIP 80301-022
Phone: (303) 440-0205
Fax: (303) 440-0209

The NPI 1831184381 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/12/2005 and was last updated on 8/15/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine45139COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10191671MEDICAIDOHIO
2C98191MEDICARE UPIN
3080188923OTHERRAILROAD MEDICARE
40790791MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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