NPIMap

Individual provider Active NPI

Miles Henson

  • Physician Assistant
  • Eagle, CO
National Provider Identifier
1588245294
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006824 Issued in CO
Practice address
377 Sylvan Lake Rd Ste 210
Eagle, CO 81631-6779
Phone
(970) 926-6340
Fax
(970) 926-6348
NPI assigned
Apr 15, 2021
Last updated
May 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X PA.0006824 CO Primary

Addresses

Primary practice location

377 Sylvan Lake Rd Ste 210
Eagle, CO 81631-6779

Mailing address

PO Box 4330
Avon, CO 81620-4330
Phone (970) 926-6340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210821000351 CO Practitioner - Physician Assistant 2961807466 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Mountain Medical, LLCGroup PAC ID 5496087181, 63 clinicians

Practice addresses (Care Compare)

180 S Frontage Rd W
Suite 5800
Vail, CO 81657-5038
Phone (970) 926-6340

181 W Meadow Dr
Vail, CO 81657-5242
Phone (970) 926-6340

365 Dillon Ridge Rd
Dillon, CO 80435-6344

377 Sylvan Lake Rd
Eagle, CO 81631-6779
Phone (970) 926-6350

50 Buck Creek Rd
Avon, CO 81620-5428

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Mountain Medical, LLC CurrentSince Aug 17, 2021 Accepting new patients
Pathology Assoc of the Roaring Fork Current Accepting new patients
Valley View Hospital Association CurrentSince Oct 1, 2022 Accepting new patients
Colorado Mountain Medical, LLC CurrentSince Aug 17, 2021 Accepting new patients
Valley View Hospital Association Current Accepting new patients
Valley View Hospital Association CurrentSince Oct 1, 2022 Accepting new patients
Valley View Hospital Association CurrentSince Aug 27, 2023 Accepting new patients
Colorado Mountain Medical, PC Past Accepting new patients

Locations

377 Sylvan Lake Rd
Ste 120
Eagle, CO 81631
Phone (970) 926-1800

377 Sylvan Lake Rd
Ste 210
Eagle, CO 81631
Phone (970) 328-1650

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

1906 Blake Ave
#C
Glenwood Springs, CO 81601
Phone (970) 384-6782

180 S Frontage Rd W
Ste 5800
Vail, CO 81657

181 W Meadow Dr
Vail, CO 81657
Phone (970) 476-1225

Organizations & group practices 10

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1588245294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4330",
            "city": "AVON",
            "state": "CO",
            "postal_code": "816204330",
            "telephone_number": "970-926-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 SYLVAN LAKE RD STE 210",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "816316779",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "MILES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, CO

Sources for this page

Verify at the official NPI Registry.