Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Bridge

Individual provider Physician Assistant · NPI 1982562724

Ethan Bridge is a Physician Assistant in Lafayette, Colorado. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Colorado.

Years since qualifying
1
Licensed in
CO
In the registry since
2026
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Practice location Address checks out

1140 W South Boulder Rd Ste 202
Lafayette, CO 80026-8910
Phone: (303) 604-1444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.0009608 (CO)

Record details

NPI number1982562724
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 12, 2026
Last updated in NPPESMarch 16, 2026
Certification dateMarch 16, 2026
Mailing address1140 W South Boulder Rd Ste 202, Lafayette, CO 80026-8910

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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