Active NPI
Samuel Anders Gagnon, PT
- Physical Therapist
- Aurora, CO
National Provider Identifier
1497695399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL.0020938
- Practice address
- 14701 E Exposition Ave
Aurora, CO 80012-2623 - Phone
- (303) 338-4545
- NPI assigned
- Mar 30, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4669 | NH | |
| Physical Therapist | 225100000X | PTL.0020938 | CO | Primary |
Addresses
Primary practice location
14701 E Exposition Ave
Aurora, CO 80012-2623
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other practice location 1
7 Alumni Dr
Exeter, NH 03833-2118
Phone (603) 778-7311
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10350 E Dakota Ave
Denver, CO 80247-1314
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0020938 | CO | MD | Physical Therapist |
| 4669 | NH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777939200000",
"number": "1497695399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10350 E DAKOTA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802471314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14701 E EXPOSITION AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800122623",
"telephone_number": "303-338-4545"
}
],
"practiceLocations": [
{
"address_1": "7 Alumni Dr",
"address_purpose": "LOCATION",
"city": "Exeter",
"state": "NH",
"postal_code": "038332118",
"country_code": "US",
"telephone_number": "603-778-7311",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAGNON",
"first_name": "SAMUEL",
"middle_name": "ANDERS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-30",
"last_updated": "2026-05-05",
"certification_date": "2026-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NH",
"license": "4669",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL.0020938",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "14701 E Exposition Ave",
"city": "Aurora",
"state": "CO",
"country_code": "US",
"postal_code": "800122623",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.