Individual provider Active NPI

Gary James Tackling, MD

  • Hospitalist Physician
  • Longmont, CO
National Provider Identifier
1598299141
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DR.0067063 Issued in CO
Practice address
1950 Mountain View Ave
Longmont, CO 80501-3129
Phone
(303) 485-3066
Fax
(303) 485-3060
NPI assigned
Apr 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME145962 FL
Internal Medicine Physician 207R00000X DR.0067063 CO
Hospitalist Physician 208M00000X DR.0067063 CO Primary

Addresses

Primary practice location

1950 Mountain View Ave
Longmont, CO 80501-3129

Mailing address

1005 Mar Walt Drive
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8100

Other practice location 1

1005 Mar Walt Drive
Internal Medicine Department
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210917000523 CO Practitioner - Hospitalist 4981941390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

1950 Mountain View Ave
Longmont, CO 80501-3129
Phone (303) 485-3066

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0067063COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Portercare Adventist Health System CurrentSince Oct 31, 2021 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 31, 2021 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 31, 2021 Accepting new patients
Portercare Adventist Health System Hospitalist CurrentSince Oct 31, 2021 Accepting new patients
Portercare Adventist Health System Current Accepting new patients

Locations

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

1950 Mountain View Ave
Longmont, CO 80501
Phone (303) 651-5000

100 Health Park Dr
Louisville, CO 80027
Phone (303) 673-1000

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1598299141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8100",
            "fax_number": "850-863-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013129",
            "telephone_number": "303-485-3066",
            "fax_number": "303-485-3060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Mar Walt Drive",
            "address_2": "Internal Medicine Department",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325476707",
            "country_code": "US",
            "telephone_number": "850-863-8202",
            "fax_number": "850-862-6148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACKLING",
        "first_name": "GARY",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME145962",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0067063",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0067063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.