Joel Travis Tanaka, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9800712 Issued in NC

Practice address

Robinson Family Medicine Clinic (Tmc10)
Fort Carson, CO 80913-4604

Phone

(719) 524-2207

Fax

(719) 524-2258

NPI assigned

Jul 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Uniformed Services Uhs Fe Hebert School of Med, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Vista Community Health CentersGroup PAC ID 4688583974, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joel.tanaka.p1@direct.peakvista.nextgenshare.com

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Peak Vista Community Health Centers

  dba Health Center at Rio Grande

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1043512023

  Corporate Officer

  CMS ownership
• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1730166034

  Corporate Officer

  CMS ownership
• Peak Vista Community Health Centers

  dba Health Center at Academy SUITE 3300

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1760252001

  Corporate Officer

  CMS ownership
• Peak Vista Community Health Centers

  dba Downtown Health Center

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1972245959

  Corporate Officer

  CMS ownership

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.

• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1730166034
  Medicare reassignment Care Compare group NPD
• Peak Vista Community Health Centers

  dba Behavioral Health at Inside Out Youth Services

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1871347443
  NPD

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356361950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC",
            "address_2": "1650 COCHRANE CIRCLE ATTN: CREDENTIALS OFFICE",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-7844",
            "fax_number": "719-526-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROBINSON FAMILY MEDICINE CLINIC (TMC10)",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-524-2207",
            "fax_number": "719-524-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "JOEL",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9800712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Swanberg, RDH
• Steven Swank, PHARMD
• Christian B Swift, ACNP-BC, FNP-BC
• Justin Michael Thomas Tafoya, DMD
• Honoria Tamayo
• Ramon Ricardo Tapia, DPT
• Narisa Ann Tappitake, MOT, OTR/L
• Bethany J Tau
• Amanda Lynn Taylor, RD
• Charles Lane Taylor, MD

• Family Medicine Physician in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.