NPIMap

Individual provider Active NPI

Charles Emerson, PA, ATC

  • Medical Physician Assistant
  • Aurora, CO
National Provider Identifier
1053863746
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0008875 Issued in CO
Practice address
12505 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Oct 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 97201 MT
Physician Assistant 363A00000X PA9109426 FL
Physician Assistant 363A00000X PA.0008875 CO
Medical Physician Assistant 363AM0700X PA.0008875 CO Primary

Addresses

Primary practice location

12505 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

11820 Destination Dr
Broomfield, CO 80021-2518
Phone (720) 848-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, WY, CO3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220624002477 MT Practitioner - Physician Assistant 9830470715 Reassigns benefits to 2 organizations
I20230718000634 WY Practitioner - Physician Assistant 9830470715 Reassigns benefits to 1 organization
I20250717004365 CO Practitioner - Physician Assistant 9830470715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Stgi Health, LLCGroup PAC ID 1850764226, 15 clinicians

Practice addresses (Care Compare)

11820 Destination Dr
Broomfield, CO 80021-2518
Phone (720) 848-0000

2126 Opal Ave
Yellowstone National Park, WY 82190
Phone (703) 578-6030

Old Faithful Clinic 122 Clinic LN
Yellowstone National Park, WY 82190
Phone (703) 578-6030

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Uchealth Broomfield Hospital Hospital, Broomfield, CO, CCN 060129

Merit-based Incentive Payment System (MIPS)

Final score
82.99 of 100Reported as group
Quality
62.64
Promoting interoperability
100
Improvement activities
40
Cost
80.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0008875COMDPhysician Assistant
PA9109426FLMDPhysician Assistant
97201MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jan 20, 2004 Accepting new patients
University Physicians, Incorporated CurrentSince Aug 1, 2025 Accepting new patients
Baylor College of Medicine CurrentSince Jan 20, 2004 Accepting new patients
Benefis Hospitals Inc CurrentSince Jun 1, 2022 Accepting new patients
Fallon Medical Complex Inc CurrentSince Aug 23, 2022 Accepting new patients
Doctx3 PLLC CurrentSince Jan 4, 2019 Accepting new patients
Fallon Medical Complex Inc CurrentSince Aug 23, 2022 Accepting new patients
University Physicians Incorporated CurrentSince Aug 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients
Texas Em-1 Medical Services, PA Physician Assistant Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

11820 Destination Dr
Broomfield, CO 80021
Phone (303) 460-6000

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

25 14th Ave NW
Great Falls, MT 59404
Phone (406) 455-4777

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1401 25th St S
Great Falls, MT 59405
Phone (406) 455-3650

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

710 Drake St
Wibaux, MT 59353
Phone (406) 778-2833

3110 Guadalupe St
Ste 100
Austin, TX 78705
Phone (512) 599-9510

709 E Slaughter Ln
Ste 404
Austin, TX 78744
Phone (512) 277-6643

9500 Dallas Pkwy
Ste 100
Frisco, TX 75033
Phone (469) 535-6647

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

3014 N O Connor Rd
Ste 200
Irving, TX 75062
Phone (214) 444-5558

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1053863746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11820 Destination Dr",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800212518",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "fax_number": "303-460-6197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "CHARLES",
        "credential": "PA, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-27",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "97201",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109426",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008875",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0008875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.