Individual provider Active NPI

Ryan P Fallt, PA-C

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1053748020
Registry record updated Jun 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3816 Issued in CO
Practice address
2045 Franklin St
Denver, CO 80205-5494
Phone
(303) 861-3302
Fax
(303) 861-3498
NPI assigned
Oct 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 3816 CO
Physician Assistant 363A00000X 3816 CO Primary

Addresses

Primary practice location

2045 Franklin St
Denver, CO 80205-5494

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other practice location 1

1721 E 19th Ave
#300
Denver, CO 80218-1251
Phone (720) 754-4800

Other identifiers 1

IdentifierTypeStateIssuer
64082881MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131108000990 CO Practitioner - Physician Assistant 7618102153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

10240 Park Meadows Dr
Lone Tree, CO 80124-5425
Phone (303) 338-4545

10350 E Dakota Ave
Denver, CO 80247-1314

10350 E Dakota Avenue B
Kaiser Permanente High
Denver, CO 80247-1314
Phone (303) 338-4545

10350 E Dakota Avenue C
Kaiser Permanente Highline Chemical
Denver, CO 80247-1314
Phone (303) 338-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3816COMDHematology & Oncology Physician

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781395200000",
    "number": "1053748020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 FRANKLIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055494",
            "telephone_number": "303-861-3302",
            "fax_number": "303-861-3498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 E 19th Ave",
            "address_2": "#300",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802181251",
            "country_code": "US",
            "telephone_number": "720-754-4800",
            "fax_number": "720-754-4801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FALLT",
        "first_name": "RYAN",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-04",
        "last_updated": "2026-06-14",
        "certification_date": "2026-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CO",
            "license": "3816",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64082881",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2045 Franklin St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802055494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.