Individual provider Active NPI

Dennis C Channel Jr., MD

  • Internal Medicine Physician
  • Glendale, CO
National Provider Identifier
1730216789
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32418 Issued in CO
Practice address
4100 E Mississippi Ave Ste 110
Glendale, CO 80246-3051
Phone
(303) 552-9522
Fax
(415) 252-7176
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32418 CO Primary

Addresses

Primary practice location

4100 E Mississippi Ave Ste 110
Glendale, CO 80246-3051

Mailing address

912 S Gilpin St
Denver, CO 80209-4521
Phone (303) 778-1312

Other practice location 1

10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
008163OtherKAISER-COMMERCIAL NUMBER
01324185MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20081204000621 CO Practitioner - Internal Medicine 3870654148 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iora Health Colorado, P.C.Group PAC ID 8426323114, 42 clinicians

Practice addresses (Care Compare)

4100 E Mississippi Ave
Suite 110
Glendale, CO 80246-3051
Phone (303) 552-9522

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32418COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iora Senior Health, LLC Internal Medicine CurrentSince Mar 24, 2025 Accepting new patients
Iora Senior Health, LLC Internal Medicine Current Accepting new patients
Iora Health Colorado, P.C. Internal Medicine CurrentSince Mar 24, 2025 Accepting new patients
Iora Senior Health, LLC Internal Medicine CurrentSince Mar 24, 2025 Accepting new patients
Iora Health Colorado, P.C. Internal Medicine CurrentSince Mar 24, 2025 Accepting new patients
Iora Health Colorado, P.C. Internal Medicine Current Accepting new patients

Locations

1080 S Sable Blvd
Unit 18
Aurora, CO 80012
Phone (303) 552-9577

4100 E Mississippi Ave
Ste 110
Glendale, CO 80246
Phone (303) 552-9522

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1730216789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S GILPIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094521",
            "telephone_number": "303-778-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 E MISSISSIPPI AVE STE 110",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802463051",
            "telephone_number": "303-552-9522",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10350 E Dakota Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802471314",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANNEL",
        "first_name": "DENNIS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "32418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "008163",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01324185",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10350 E Dakota Ave",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802471314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, CO

Sources for this page

Verify at the official NPI Registry.