Individual provider Active NPI

Natalia Sedova Tucker, M.D.

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1639306509
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0074042 Issued in CO
Practice address
700 Colorado Blvd # 214
Denver, CO 80206-4084
Phone
(314) 250-4165
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MDR-5741 HI
Student in an Organized Health Care Education/Training Program 390200000X TL.0008850 CO
Family Medicine Physician 207Q00000X DR.0074042 CO Primary

Addresses

Primary practice location

700 Colorado Blvd # 214
Denver, CO 80206-4084

Mailing address

700 Colorado Blvd # 214
Denver, CO 80206-4084
Phone (314) 250-4165

Other practice location 1

1356 Lusitana St Fl 6
Honolulu, HI 96813-2409
Phone (314) 250-4165

Other practice location 2

777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4949

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210630001828 CO Practitioner - Family Practice 0446651293 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR-5741HIMDSurgery Physician
TL.0008850COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Dec 15, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Dec 15, 2024 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

4995 E 33rd Ave
Denver, CO 80207
Phone (303) 602-3720

777 Bannock St
#1923
Denver, CO 80204
Phone (303) 602-2720

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: ntucker265783@direct.dhha.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1639306509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 COLORADO BLVD # 214",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802064084",
            "telephone_number": "314-250-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 COLORADO BLVD # 214",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802064084",
            "telephone_number": "314-250-4165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1356 Lusitana St Fl 6",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132409",
            "country_code": "US",
            "telephone_number": "314-250-4165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Bannock St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044597",
            "country_code": "US",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-3733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "NATALIA",
        "middle_name": "SEDOVA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "HI",
            "license": "MDR-5741",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL.0008850",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0074042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.