NPIMap

Individual provider Active NPI

Jacob Mark Altholz, MD

  • Emergency Medicine Physician
  • Aurora, CO
National Provider Identifier
1629655279
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0069501 Issued in CO
Practice address
12505 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Mar 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DR.0069501 CO Primary

Addresses

Primary practice location

12505 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

12605 E 16TH Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Other practice location 1

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-2273

Other practice location 2

11820 Destination Dr
Broomfield, CO 80021-2518
Phone (720) 848-0000

Other practice location 3

901 Rancho Ln Ste 135
Las Vegas, NV 89106-3826
Phone (303) 359-8665

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
I20241218000749 CO Practitioner - Emergency Medicine 4789111592 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLC 2,425 clinicians
University Physicians Incorporated 3,189 clinicians

Practice addresses (Care Compare)

11820 Destination Dr
Broomfield, CO 80021-2518
Phone (720) 848-0000

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Uchealth Highlands Ranch Hospital Hospital, Highlands Ranch, CO, CCN 060132

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Jan 1, 2025 Accepting new patients
University Physicians Incorporated Emergency Medicine Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 1, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 24, 2025 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 24, 2025 Accepting new patients
University Physicians Incorporated CurrentSince Jan 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

11820 Destination Dr
Broomfield, CO 80021
Phone (303) 460-6000

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

777 Bannock St
Denver, CO 80204

Dept 1061
Denver, CO 80256

Interoperability endpoints

  • Direct secure messaging: jaltholz51043@direct.childrenscolorado.org

Organizations & group practices 8

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1629655279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11820 Destination Dr",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800212518",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "fax_number": "303-460-6197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Rancho Ln Ste 135",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891063826",
            "country_code": "US",
            "telephone_number": "303-359-8665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTHOLZ",
        "first_name": "JACOB",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0069501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.