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Portercare Adventist Health System

Organization Active NPI Surgical Oncology Physician · Denver, CO

NPI 1750114971 · NPPES record last updated Aug 22, 2024

Key facts

NPI
1750114971
Entity type
Organization (NPI type 2)
Primary specialty
Surgical Oncology Physician 2086X0206X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Practice address
950 E Harvard Ave Ste 550
Denver, CO 80210-7000
Phone
(303) 765-6777
Fax
(720) 543-1758
NPI assigned
Aug 22, 2024
Organization subpart
No

Authorized official

Name
Mr. 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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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
Surgical Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086X0206X Yes

Addresses

Primary practice location

950 E Harvard Ave Ste 550
Denver, CO 80210-7000

Mailing address

PO Box 713425
Chicago, IL 60677-4325

Other names

  • AdventHealth Medical Group Thoracic Surgical Oncology at Porter 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 Aug 22, 2024.

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1750114971",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E HARVARD AVE STE 550",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802107000",
            "telephone_number": "303-765-6777",
            "fax_number": "720-543-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group Thoracic Surgical Oncology at Porter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

All providers in Denver, CO · Surgical Oncology Physician in Colorado

Sources for this page

Verify at the official NPI Registry.