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Portercare Adventist Health System

Organization Active NPI Surgery Physician · Louisville, CO

NPI 1740141829 · NPPES record last updated Nov 19, 2025

Key facts

NPI
1740141829
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Practice address
80 Health Park Dr Ste 270
Louisville, CO 80027-4644
Phone
(303) 734-2023
Fax
(720) 896-4018
NPI assigned
Nov 19, 2025
Organization subpart
No

Authorized official

Name
Jason Tacha
Title
Coo
Phone
(303) 304-7752

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090115000327 CO Part B Supplier - Clinic/Group Practice 0941110886 Receives reassigned benefits from 869 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Avista Adventist Hospital (210 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X Yes

Addresses

Primary practice location

80 Health Park Dr Ste 270
Louisville, CO 80027-4644

Mailing address

PO Box 713425
Chicago, IL 60677-4325
Phone (800) 953-0104

Other names

  • AdventHealth Medical Group General Surgery at Louisville Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 19, 2025.

{
    "created_epoch": "1763510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1740141829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713425",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606774325",
            "telephone_number": "800-953-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HEALTH PARK DR STE 270",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800274644",
            "telephone_number": "303-734-2023",
            "fax_number": "720-896-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "TACHA",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "303-304-7752"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group General Surgery at Louisville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, CO

All providers in Louisville, CO · Surgery Physician in Colorado

Sources for this page

Verify at the official NPI Registry.