NPIMap

Individual provider Active NPI

Nicholas Robert Polise, D.O.

  • Hospitalist Physician
  • Littleton, CO
National Provider Identifier
1235588021
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0005955 Issued in CO
Practice address
7700 S Broadway
Littleton, CO 80122-2602
Phone
(303) 730-8900
Fax
(303) 738-7755
NPI assigned
Jun 13, 2016
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0005955 CO
Hospitalist Physician 208M00000X 0005955 CO Primary

Addresses

Primary practice location

7700 S Broadway
Littleton, CO 80122-2602

Mailing address

PO Box 800022
Kansas City, MO 64180-0022
Phone (800) 953-0104

Other practice location 1

400 W 16th St
Pueblo, CO 81003-2745
Phone (719) 595-7585

Other practice location 2

14300 Orchard Pkwy
Westminster, CO 80023
Phone (720) 627-3761

Other identifiers 1

IdentifierTypeStateIssuer
9000141319MedicaidCO

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
I20190814002976 CO Practitioner - HospitalistPractitioner - Internal Medicine 4981941036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527

11650 W 2ND PL
Lakewood, CO 80228-1527

14300 Orchard Pkwy
Westminster, CO 80023-9206
Phone (720) 627-0207

14300 Orchard Pkwy Floor 2 Pod
1 Ornh Pain Specialists
Westminster, CO 80023-9206
Phone (303) 661-4100

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0005955COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado Family Medicine CurrentSince May 15, 2020 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System Family Medicine CurrentSince May 15, 2020 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince May 15, 2020 Accepting new patients
Portercare Adventist Health System CurrentSince May 15, 2020 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients
Total Longterm Care, Inc. Past Accepting new patients
Catholic Health Iniatives Colorado Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1235588021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800022",
            "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": "7700 S BROADWAY",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222602",
            "telephone_number": "303-730-8900",
            "fax_number": "303-738-7755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W 16th St",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810032745",
            "country_code": "US",
            "telephone_number": "719-595-7585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14300 Orchard Pkwy",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CO",
            "postal_code": "80023",
            "country_code": "US",
            "telephone_number": "720-627-3761",
            "fax_number": "720-627-3758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLISE",
        "first_name": "NICHOLAS",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "0005955",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "0005955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000141319",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.