NPIMap

Individual provider Active NPI

Jim Minh DO, MD

  • Family Medicine Physician
  • Brighton, CO
National Provider Identifier
1730617192
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0064352 Issued in CO
Practice address
859 S 4TH Ave
Brighton, CO 80601-3205
Phone
(303) 338-4545
NPI assigned
May 30, 2017
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TL0006807 CO
Family Medicine Physician 207Q00000X DR.0064352 CO Primary

Addresses

Primary practice location

859 S 4TH Ave
Brighton, CO 80601-3205

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other practice location 1

1190 US Highway 287
Broomfield, CO 80020-7021
Phone (303) 544-3800

Other identifiers 2

IdentifierTypeStateIssuer
9000157946MedicaidCO
029069OtherCOKAISER COMMERCIAL NUMBER

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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200716003906 CO Practitioner - Family Practice 9234409236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

859 S 4TH Ave
Kaiser Permanente Brighton Medical
Brighton, CO 80601-3205
Phone (303) 338-4545

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0064352COMDFamily Medicine Physician
TL0006807COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2023 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients

Locations

1190 US Highway 287
Broomfield, CO 80020
Phone (303) 544-3800

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1730617192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 S 4TH AVE",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806013205",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 US Highway 287",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800207021",
            "country_code": "US",
            "telephone_number": "303-544-3800",
            "fax_number": "303-544-3810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "JIM",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL0006807",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0064352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000157946",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029069",
            "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": "859 S 4th Ave",
            "city": "Brighton",
            "state": "CO",
            "country_code": "US",
            "postal_code": "806013205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

Verify at the official NPI Registry.