NPIMap

Individual provider Active NPI

Charles E Tawa, MD

  • Family Medicine Physician
  • Dacono, CO
National Provider Identifier
1437116555
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28790 Issued in CO
Practice address
4943 State Highway 52
Dacono, CO 80514-9100
Phone
(303) 501-2600
Fax
(303) 833-7017
NPI assigned
May 1, 2006
Last updated
Feb 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28790 CO Primary

Addresses

Primary practice location

4943 State Highway 52
Dacono, CO 80514-9100

Mailing address

4943 State Highway 52
Dacono, CO 80514-9100
Phone (303) 501-2600

Other identifiers 2

IdentifierTypeStateIssuer
C805562OtherCOMEDICARE
01287903MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 2, 2020 through Dec 2, 2026

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1902 Kristy Court
Longmont, CO 80504

2017 100 Yearparty CT
Unit 1
Longmont, CO 80504

2017 100 Yearparty CT
Unit 1
Longmont, CO 80504-8483

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28790COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Family Medicine, PC Family Medicine PastSince Apr 16, 2005 Accepting new patients
Registered Physical Therapy Associates, PC Past Accepting new patients
Boulder Family Practice Clinic Family Medicine Past Accepting new patients

Organizations & group practices 3

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1437116555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4943 STATE HIGHWAY 52",
            "city": "DACONO",
            "state": "CO",
            "postal_code": "805149100",
            "telephone_number": "303-501-2600",
            "fax_number": "303-833-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4943 STATE HIGHWAY 52",
            "city": "DACONO",
            "state": "CO",
            "postal_code": "805149100",
            "telephone_number": "303-501-2600",
            "fax_number": "303-833-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWA",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "28790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "C805562",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01287903",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacono, CO

Sources for this page

Verify at the official NPI Registry.