Portercare Adventist Health System

Organization Active NPI Orthopaedic Surgery Physician · Cheyenne, WY

NPI 1497498653 · NPPES record last updated Aug 12, 2026

Key facts

NPI
1497498653
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Practice address
4028 Laramie St
Cheyenne, WY 82001-2064
Phone
(720) 524-1367
Fax
(720) 524-1422
NPI assigned
Apr 15, 2022
Organization subpart
No

Authorized official

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

Owned or controlled facilities with NPI records 1

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

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 770

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 770

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WY

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Encompass Health Rehabilitation Hospital of Littleton
Littleton, CO · CCN 063034
Hospital 5% Or Greater Direct Ownership Interest (32%) Nov 1, 2018

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220629000205 WY Part B Supplier - Clinic/Group Practice 0941110886 Receives reassigned benefits from 3 practitioners
Practice locations: Cheyenne, WY

National Provider Directory

Locations

4028 Laramie St
Cheyenne, WY 82001
Phone (307) 635-2562

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207X00000X Yes

Addresses

Primary practice location

4028 Laramie St
Cheyenne, WY 82001-2064

Mailing address

PO Box 713425
Chicago, IL 60677-4325
Phone (800) 953-0104

Other names

  • AdventHealth Medical Group Colorado Joint Replacement at Cheyenne Doing business as

Other providers in Cheyenne, WY

All providers in Cheyenne, WY · Orthopaedic Surgery Physician in Wyoming

Sources for this page

Verify at the official NPI Registry.