Individual provider Active NPI

David Mata Canadas

  • Diagnostic Radiology Physician
  • Englewood, CO
National Provider Identifier
1871101048
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DR.0076917 Issued in CO
Practice address
10800 E Geddes Ave Ste 300
Englewood, CO 80112-3895
Phone
(303) 761-9190
Fax
(720) 874-4462
NPI assigned
Jul 14, 2020
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X DR.0076917 CO
Diagnostic Radiology Physician 2085R0202X DR.0076917 CO Primary

Addresses

Primary practice location

10800 E Geddes Ave Ste 300
Englewood, CO 80112-3895

Mailing address

10800 E Geddes Ave Ste 300
Englewood, CO 80112-3895
Phone (303) 761-9190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260512003041 CO Practitioner - Diagnostic Radiology 2264901917 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2 Meridian Blvd
FL 3
Wyomissing, PA 19610-3202

2901 N Central Ave
Phoenix, AZ 85012-2702

525 W Brown Rd
Mesa, AZ 85201-3202

PO Box
Pittsburgh, PA 15251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DR.0076917COMDDiagnostic Radiology Physician

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1871101048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 E GEDDES AVE STE 300",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801123895",
            "telephone_number": "303-761-9190",
            "fax_number": "720-874-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 E GEDDES AVE STE 300",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801123895",
            "telephone_number": "303-761-9190",
            "fax_number": "720-874-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA CANADAS",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CO",
            "license": "DR.0076917",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0076917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.