Active NPI
Kaley Tucker, PA-C
- Medical Physician Assistant
- Littleton, CO
National Provider Identifier
1114269024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA0003630
- Practice address
- 5920 S Estes St Ste 250
Littleton, CO 80123-8620 - Phone
- (303) 973-3529
- Fax
- (303) 973-3549
- NPI assigned
- Mar 19, 2013
- Last updated
- Feb 7, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA0003630 | CO | Primary |
Addresses
Primary practice location
5920 S Estes St Ste 250
Littleton, CO 80123-8620
Mailing address
5920 S Estes St Ste 250
Littleton, CO 80123-8620
Phone (303) 973-3529
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA0003630 | Other | CO | PA-C LICENSE |
| 1922351758 | Other | NPI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@peakhealthmedicine.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260
5920 S Estes St
Suite 250
Littleton, CO 80123-8620
Phone (303) 973-3529
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0003630 | CO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Current | Accepting new patients |
Locations
5920 S Estes St
Ste 250
Littleton, CO 80123
Phone (303) 973-3529
2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba UCHealth Medical Group
- General Practice Physician
- Loveland, CO
- NPI 1225356868
-
dba UCHealth Medical Group
- General Practice Physician
- Loveland, CO
- NPI 1366763260
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth West Littleton ER
- General Acute Care Hospital
- Littleton, CO
- NPI 1548800154
-
dba Adventhealth Littleton
- General Acute Care Hospital
- Littleton, CO
- NPI 1689688988
-
dba South Denver Heart Center
- General Acute Care Hospital
- Littleton, CO
- NPI 1720628332
-
- General Acute Care Hospital
- Highlands Ranch, CO
- NPI 1891294518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581033600000",
"number": "1114269024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5920 S ESTES ST STE 250",
"city": "LITTLETON",
"state": "CO",
"postal_code": "801238620",
"telephone_number": "303-973-3529",
"fax_number": "303-973-3549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5920 S ESTES ST STE 250",
"city": "LITTLETON",
"state": "CO",
"postal_code": "801238620",
"telephone_number": "303-973-3529",
"fax_number": "303-973-3549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "KALEY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-19",
"last_updated": "2020-02-07",
"certification_date": "2020-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA0003630",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA-C LICENSE",
"identifier": "PA0003630",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1922351758",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@peakhealthmedicine.com",
"affiliation": "N",
"address_1": "5920 S Estes St Ste 250",
"city": "Littleton",
"state": "CO",
"country_code": "US",
"postal_code": "801238620",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Littleton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.