NPIMap

Individual provider Active NPI

Natalie Lucille Tannenbaum

  • Surgical Physician Assistant
  • Englewood, CO
National Provider Identifier
1003492364
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
3501 S Clarkson St
Englewood, CO 80113-3916
Phone
(303) 783-8844
NPI assigned
Mar 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.0006741 CO
Surgical Physician Assistant 363AS0400X CO Primary

Addresses

Primary practice location

3501 S Clarkson St
Englewood, CO 80113-3916

Mailing address

15455 Canyon Rim Dr Unit 207
Englewood, CO 80112-4731
Phone (303) 726-2364

Other practice location 1

9949 S Oswego St Ste 300
Parker, CO 80134-3888
Phone (303) 925-4638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211025001232 CO Practitioner - Physician Assistant 3577951573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portercare Adventist Health SystemGroup PAC ID 0941110886, 770 clinicians

Practice addresses (Care Compare)

2535 S Downing St
Denver, CO 80210-5850
Phone (303) 778-5797

7700 S Broadway
Littleton, CO 80122-2602
Phone (303) 730-8900

9395 Crown Crest Blvd
Parker, CO 80138-8573
Phone (303) 269-4975

9949 S Oswego St
Parker, CO 80134-3888

Hospital & facility affiliations

  • AdventHealth Parker Hospital, Parker, CO, CCN 060114
  • AdventHealth Littleton Hospital, Littleton, CO, CCN 060113
  • Adventhealth Castle Rock Hospital, Castle Rock, CO, CCN 060125

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
78.58
Promoting interoperability
100
Improvement activities
40
Cost
74.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0006741COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince May 1, 2023 Accepting new patients
Portercare Adventist Health System CurrentSince May 1, 2023 Accepting new patients
Portercare Adventist Health System PastSince May 25, 2021 Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

7720 S Broadway
Ste 250
Littleton, CO 80122
Phone (720) 922-6240

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

9949 S Oswego St
Ste 300
Parker, CO 80134
Phone (303) 649-3100

Interoperability endpoints

  • Direct secure messaging: ntannenbaum1854905@adventhealth.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1003492364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15455 CANYON RIM DR UNIT 207",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801124731",
            "telephone_number": "303-726-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S CLARKSON ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133916",
            "telephone_number": "303-783-8844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9949 S Oswego St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801343888",
            "country_code": "US",
            "telephone_number": "303-925-4638",
            "fax_number": "303-925-4651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "NATALIE",
        "middle_name": "LUCILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0006741",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.