NPIMap

Individual provider Active NPI

Sourav Poddar, MD

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1750496733
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37379 Issued in CO
Practice address
2000 S Colorado Blvd
Denver, CO 80222-7900
Phone
(720) 848-8201
NPI assigned
Aug 20, 2006
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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 37379 CO Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 37379 CO

Addresses

Primary practice location

2000 S Colorado Blvd
Denver, CO 80222-7900

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

Other practice location 1

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

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
I20100323000385 CO Practitioner - Family PracticePractitioner - Sports MedicinePractitioner - Hospitalist 7012042583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist, Sports Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37379COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated Sports Medicine CurrentSince Aug 13, 2001 Accepting new patients
University Physicians Incorporated Family Medicine CurrentSince Aug 13, 2001 Accepting new patients
University Physicians, Incorporated Past Accepting new patients
HCA-Healthone, LLC Dba Rose Family Medicine Center Family Medicine Past Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

2150 Stadium Dr
Boulder, CO 80309
Phone (303) 315-9900

2150 Stadium Dr 2nd
Boulder, CO 80309
Phone (303) 315-9900

2150 Stadium Dr 368 Ucb
Boulder, CO 80309

2000 S Colorado Blvd
Denver, CO 80222
Phone (303) 607-0174

2000 S Colorado Blvd
Bldg 1-4500
Denver, CO 80222
Phone (720) 848-8200

4545 E 9th Ave
Ste 10
Denver, CO 80220
Phone (303) 320-2121

Dept 1061
Denver, CO 80256

175 Inverness Dr W
Ste 200
Englewood, CO 80112
Phone (303) 469-3182

Organizations & group practices 4

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1750496733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S COLORADO BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802227900",
            "telephone_number": "720-848-8201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PODDAR",
        "first_name": "SOURAV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "37379",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CO",
            "license": "37379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.