NPIMap

Organization Active NPI

Portercare Adventist Health System

Doing business as AdventHealth Medical Group Endocrine Surgery at Parker

  • Surgery Physician
  • Parker, CO
National Provider Identifier
1295549731
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
AdventHealth Medical Group Endocrine Surgery at Parker
Practice address
9399 Crown Crest Blvd Ste 240
Parker, CO 80138-8571
Phone
(720) 330-1310
Fax
(720) 452-2082
NPI assigned
Feb 5, 2025
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Mr. Jason Tacha
Title
Coo
Phone
(303) 304-7752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

9399 Crown Crest Blvd Ste 240
Parker, CO 80138-8571

Mailing address

PO Box 713425
Chicago, IL 60677-4325

Other names 1

  • AdventHealth Medical Group Endocrine Surgery at Parker Doing business as

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 Clinical Laborat216 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1295549731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713425",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606774325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9399 CROWN CREST BLVD STE 240",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388571",
            "telephone_number": "720-330-1310",
            "fax_number": "720-452-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "TACHA",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "303-304-7752",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group Endocrine Surgery at Parker",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.