NPIMap

Individual provider Active NPI

Carolyn S Im

  • Surgical Physician Assistant
  • Englewood, CO
National Provider Identifier
1912550989
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
3501 S Clarkson St
Englewood, CO 80113-3916
Phone
(303) 783-8844
Fax
(303) 783-2002
NPI assigned
Jul 19, 2019
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0006728 CO
Medical Physician Assistant 363AM0700X PA.0006728 CO
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

3501 S Clarkson St
Englewood, CO 80113-3916

Mailing address

3501 S Clarkson St
Englewood, CO 80113-3916
Phone (303) 783-8844

Other identifiers 1

IdentifierTypeStateIssuer
100096114MedicaidWI

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
I20220215000736 CO Practitioner - Physician Assistant 4183059694 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2525 S Downing St
Denver, CO 80210-5817

2535 D S Downing St
Suite 460
Denver, CO 80210-5817
Phone (303) 744-1065

2535 S Downing St
Denver, CO 80210-5850
Phone (303) 778-5797

7700 S Broadway
Littleton, CO 80122-2602
Phone (303) 730-8900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
78.58
Promoting interoperability
100
Improvement activities
40
Cost
74.61

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Sep 1, 2025 Accepting new patients
Usacs of Colorado Inc CurrentSince Feb 19, 2025 Accepting new patients
Onpoint Medical Group, LLC CurrentSince Mar 7, 2022 Accepting new patients
Portercare Adventist Health System CurrentSince Sep 1, 2022 Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Sep 22, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Sep 1, 2025 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Sep 1, 2022 Accepting new patients
Emergency Service Physicians, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Sep 22, 2024 Accepting new patients
Onpoint Medical Group, LLC CurrentSince Mar 7, 2022 Accepting new patients
Usacs of Colorado Inc CurrentSince Feb 19, 2025 Accepting new patients
Pahs Onpoint Urgent Care LLC Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Sep 1, 2022 Accepting new patients
Portercare Adventist Health System CurrentSince Sep 1, 2022 Accepting new patients

Locations

1805 Shea Center Dr
Ste 301
Highlands Ranch, CO 80129
Phone (303) 357-2559

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

7335 S Pierce St
Littleton, CO 80128
Phone (303) 932-1919

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

9218 Kimmer Dr
Ste 207
Lone Tree, CO 80124
Phone (720) 493-9006

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Interoperability endpoints

  • Direct secure messaging: cim1859361@adventhealth.direct-ci.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1912550989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 S CLARKSON ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133916",
            "telephone_number": "303-783-8844",
            "fax_number": "303-783-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S CLARKSON ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133916",
            "telephone_number": "303-783-8844",
            "fax_number": "303-783-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "CAROLYN",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006728",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0006728",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096114",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.