NPIMap

Individual provider Active NPI

Ross Tanick

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1093149254
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0071997 Issued in CO
Practice address
1700 N Marion St
Denver, CO 80218-1121
Phone
(303) 860-7770
Fax
(303) 860-7775
NPI assigned
Aug 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0071997 CO Primary
Counselor 101Y00000X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1700 N Marion St
Denver, CO 80218-1121

Mailing address

1700 N Marion St
Denver, CO 80218-1121
Phone (303) 860-7770

Other practice location 1

601 E Hampden Ave Ste 470
Englewood, CO 80113-2797
Phone (303) 788-3100

Other practice location 2

615 Piikoi St
#203
Honolulu, HI 96814-3116
Phone (808) 589-1829

Other identifiers 1

IdentifierTypeStateIssuer
UNKNOWNMedicaidCO

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
I20251205003645 CO Practitioner - Family Practice 2365821329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rocky Vista University College of Osteopathic Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1700 N Marion St
Denver, CO 80218-1121
Phone (303) 860-7770

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 8, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 8, 2025 Accepting new patients
Hale Kipa, Inc. Past Accepting new patients

Locations

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

1700 N Marion St
Denver, CO 80218
Phone (303) 830-6666

Interoperability endpoints

  • Direct secure messaging: ross.tanick@hca3.eclinicaldirectplus.com

Organizations & group practices 3

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1093149254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N MARION ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181121",
            "telephone_number": "303-860-7770",
            "fax_number": "303-860-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N MARION ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181121",
            "telephone_number": "303-860-7770",
            "fax_number": "303-860-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Hampden Ave Ste 470",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "801132797",
            "country_code": "US",
            "telephone_number": "303-788-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 Piikoi St",
            "address_2": "#203",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968143116",
            "country_code": "US",
            "telephone_number": "808-589-1829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANICK",
        "first_name": "ROSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-23",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0071997",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UNKNOWN",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.