NPIMap

Organization Active NPI

Mile High Sports and Rehabilitation Medicine, PC

  • Physical Medicine & Rehabilitation Physician
  • Denver, CO
National Provider Identifier
1427243146
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
33675 Issued in CO
Legal business name
MILE HIGH SPORTS AND REHABILITATION MEDICINE, PC
Practice address
2490 W 26TH Avenue
Suite 10-a
Denver, CO 80211
Phone
(303) 331-6744
Fax
(303) 331-6839
NPI assigned
Sep 6, 2007
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Samuel Y Chan, M.D.NPI 1508830811
Title
President
Phone
(303) 331-6744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 33675 CO Primary

Addresses

Primary practice location

2490 W 26TH Avenue
Suite 10-a
Denver, CO 80211

Mailing address

2490 W 26TH Avenue
Suite 10-a
Denver, CO 80211
Phone (303) 331-6744

Other names 1

  • Samuel Y. Chan, M.D. P.C. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051011000479 CO Part B Supplier - Clinic/Group Practice 3779508551 Receives reassigned benefits from 7 practitioners
Practice locations: Denver, CO

National Provider Directory

National Provider Directory
Tax ID family
Mile High Sports and Rehab4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

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": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1427243146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 W 26TH AVENUE",
            "address_2": "SUITE 10-A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "303-331-6744",
            "fax_number": "303-331-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 W 26TH AVENUE",
            "address_2": "SUITE 10-A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "303-331-6744",
            "fax_number": "303-331-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILE HIGH SPORTS AND REHABILITATION MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-331-6744",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "33675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samuel Y. Chan, M.D. P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.