NPIMap

Organization Active NPI

Portercare Adventist Health System

Doing business as Bcav Breastcare Avista

  • Surgery Physician
  • Louisville, CO
National Provider Identifier
1053920165
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
Bcav Breastcare Avista
Practice address
80 Health Park Dr Ste 270
Louisville, CO 80027-4644
Phone
(303) 925-4030
Fax
(303) 661-1856
NPI assigned
Jul 24, 2020
Last updated
Jul 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Mrs. Angela J Skinner
Title
Administrator, Oma
Phone
(303) 673-7175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

80 Health Park Dr Ste 270
Louisville, CO 80027-4644

Mailing address

PO Box 801106
Kansas City, MO 64180-1106
Phone (800) 953-0104

Other names 2

  • BCAV BREASTCARE AVISTA Doing business as
  • Centura Health Physician Group Center for Breast Care PAHS Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090115000327 CO Part B Supplier - Clinic/Group Practice 0941110886 Receives reassigned benefits from 869 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Porter Memorial Hospita217 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

145 Inverness Dr E
Ste 220
Englewood, CO 80112
Phone (303) 369-6060

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1053920165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801106",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801106",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HEALTH PARK DR STE 270",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800274644",
            "telephone_number": "303-925-4030",
            "fax_number": "303-661-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR, OMA",
        "authorized_official_telephone_number": "303-673-7175",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BCAV BREASTCARE AVISTA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centura Health Physician Group Center for Breast Care PAHS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.