NPIMap

Organization Active NPI

Portercare Adventist Health System

Doing business as AdventHealth Medical Group Gastroenterology at Louisville

  • Gastroenterology Physician
  • Louisville, CO
National Provider Identifier
1780988691
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
AdventHealth Medical Group Gastroenterology at Louisville
Practice address
80 Health Park Dr
Suite 270
Louisville, CO 80027-9584
Phone
(303) 269-2085
Fax
(303) 269-2089
NPI assigned
Jan 6, 2011
Last updated
Aug 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

80 Health Park Dr
Suite 270
Louisville, CO 80027-9584

Mailing address

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

Other names 2

  • AdventHealth Medical Group Gastroenterology at Louisville Doing business as
  • Northwest Gastroenterology Specialists Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2023229Adventhealth Medical Group Gastroenterology80 Health Park Dr, Ste 270, Louisville, CO 80027Certificate of waiverApr 18, 2027

National Provider Directory

National Provider Directory

Locations

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1780988691",
    "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",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HEALTH PARK DR",
            "address_2": "SUITE 270",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279584",
            "telephone_number": "303-269-2085",
            "fax_number": "303-269-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-06",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "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": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group Gastroenterology at Louisville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northwest Gastroenterology Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.