Active NPI
Portercare Adventist Health System
Doing business as Avista Surgery Center
- Ambulatory Surgical Clinic/Center
- Boulder, CO
National Provider Identifier
1962042499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- PORTERCARE ADVENTIST HEALTH SYSTEM
- Doing business as
- Avista Surgery Center
- Practice address
- 2525 4TH St Ste 201
Boulder, CO 80304-4014 - Phone
- (303) 715-7000
- NPI assigned
- Jan 13, 2020
- Last updated
- May 21, 2025
- Organization subpart
- Yes
- Parent organization
- PORTER ADVENTIST HEALTH SYSTEM
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jonathan Erickson
- Title
- Cfo
- Phone
- (303) 673-1280
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | NU | Primary |
Addresses
Primary practice location
2525 4TH St Ste 201
Boulder, CO 80304-4014
Mailing address
PO Box 713425
Chicago, IL 60677-4325
Other names 2
- Avista Surgery Center
- AdventHealth Surgery Center Boulder
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.mettles.com/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050511000798 | CO | Part A Provider - Hospital | 0941110886 |
8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Littleton, CO; Westminster, CO; Parker, CO; Louisville, CO; Denver, CO; Castle Rock, CO |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1962042499. Details of each certification follow.
Hospital certification: CCN 060103
- Legal name
- PORTERCARE ADVENTIST HEALTH SYSTEM
- Doing business as
- ADVENTHEALTH AVISTA
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- May 14, 1990
- Last certification
- Feb 28, 2019
- Beds
- 114
- Ownership / control type
- Church
- Organization structure
- Corporation
- Enrollment address
- 100 Health Park Dr
Louisville, CO 80027-9583 - Hospital subgroups
- General, Acute care
Other NPIs on the same Medicare enrollment 8
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- General Acute Care Hospital
- Westminster, CO
- NPI 1003456534
O20050511000798
-
- General Acute Care Hospital
- Westminster, CO
- NPI 1184264798
O20050511000798
-
dba Adventhealth Hematology and Oncology Castle Rock
- General Acute Care Hospital
- Castle Rock, CO
- NPI 1215824180
O20050511000798
-
dba AdventHealth Sports Med & Rehab Church Ranch
- General Acute Care Hospital
- Westminster, CO
- NPI 1275380610
O20050511000798
-
dba AdventHealth Hematology and Oncology Littleton
- General Acute Care Hospital
- Littleton, CO
- NPI 1528608056
O20050511000798
-
dba AdventHealth Hematology and Oncology Parker
- General Acute Care Hospital
- Parker, CO
- NPI 1760022297
O20050511000798
-
dba AdventHealth Hematology and Oncology Denver
- General Acute Care Hospital
- Denver, CO
- NPI 1821638354
O20050511000798
-
dba Adventhealth Avista
- General Acute Care Hospital
- Louisville, CO
- NPI 1891709192
O20050511000798
Care Compare: Hospital
Medicare Care Compare- Listed as
- Adventhealth Avista
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Church
- Medicare certification status
- Active
- Emergency services
- No
National Provider Directory
National Provider Directory- Part of
- Porter Clinical Laborat
Ownership & related parties
All disclosed owners & managing parties 31
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Gary Thurber | Corporate Director | Aug 1, 2023 | |
| Jeremy Pittman | Corporate Officer | Apr 4, 2024 | |
| David Vandevere | Corporate Director | Aug 21, 2025 | |
| Brett Spenst | Corporate Officer | Aug 1, 2023 | |
| Corporate Director | Aug 1, 2023 | ||
| Mary Ann Littler | Corporate Director | Aug 1, 2023 | |
| Jeffrey Graff | Corporate Officer | Sep 11, 2014 | |
| Lesley Radocy | Corporate Director | Jul 1, 2022 | |
| Diane Godfrey | Corporate Officer | Dec 11, 2025 | |
| Karsten Randolph | Corporate Director | Aug 1, 2023 | |
| Jill Mendoza | Corporate Director | Jul 1, 2021 | |
| Richard D'Ambrosio | Corporate Officer | Aug 24, 2023 | |
| Andrew D Jahn | Corporate Officer | Apr 1, 2024 | |
| Corporate Director | Apr 1, 2024 | ||
| Marisa Farabaugh | Corporate Officer | Apr 9, 2026 | |
| Michael Saunders | Corporate Officer | Aug 24, 2023 | |
| Lars Houmann | Corporate Director | Aug 1, 2023 | |
| John Spiers | Corporate Director | Jul 1, 2022 | |
| Lief a Sorensen | Contracted Managing Employee | Feb 8, 2026 | |
| Corporate Director | Feb 8, 2026 | ||
| Operational/Managerial Control | Feb 8, 2026 | ||
| David a Weis | Corporate Officer | Jan 1, 2026 | |
| Corporate Director | Apr 9, 2026 | ||
| Adventist Health System Sunbelt Healthcare Corporation | 5% Or Greater Direct Ownership Interest | Oct 1, 2001 | 100% |
| Toni Berrios | Corporate Officer | Aug 24, 2023 | |
| Haney Vincent | Corporate Officer | Dec 9, 2021 | |
| Douglas Pytlinski | Corporate Officer | Apr 9, 2026 | |
| Todd a Goodman | Corporate Officer | Feb 1, 2026 | |
| Jonathan L Erickson | Contracted Managing Employee | Sep 11, 2023 | |
| Corporate Officer | Sep 11, 2023 | ||
| Operational/Managerial Control | Sep 11, 2023 | ||
| David L Huffman | Corporate Officer | Aug 22, 2024 | |
| Geoff Patterson | Corporate Director | Jul 1, 2022 | |
| Robert C Foltz | Corporate Officer | Sep 11, 2014 | |
| Lynn Addiscott | Corporate Officer | Nov 10, 2005 | |
| Scott Bustos | Corporate Director | Jul 1, 2023 | |
| Karla Nugent | Corporate Director | Jul 1, 2022 | |
| Beverly Morgan | Corporate Officer | Aug 21, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Anesthesiology Physician
- Superior, CO
- NPI 1770639452
Contracted Managing Employee, Corporate Director, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 340
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578873600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747785600000",
"number": "1962042499",
"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": "2525 4TH ST STE 201",
"city": "BOULDER",
"state": "CO",
"postal_code": "803044014",
"telephone_number": "303-715-7000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PORTER ADVENTIST HEALTH SYSTEM",
"enumeration_date": "2020-01-13",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A",
"authorized_official_last_name": "ERICKSON",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "303-673-1280"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://www.mettles.com/",
"affiliation": "N",
"endpointDescription": "2.16.840.1.113883.3.6037.1",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "10320 Little Patuxent Pkwy Ste 233-02",
"city": "Columbia",
"state": "MD",
"country_code": "US",
"postal_code": "210443313",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Avista Surgery Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Avista Surgery Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "AdventHealth Surgery Center Boulder",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Boulder, CO
- Devan Pope, MA, LPCC
- Sara M Pope, M.D.
- Suzanne Pope, PHD
- Portercare Adventist Health System (Centura Health Physician Group Women's Health Boulder)
- Portercare Adventist Health System (Avista Adventist Hospital)
- Portercare Adventist Health System (Boulder Holistic Medical Center)
- Natalie Portman-Marsh, LCSW
- Sharon Elaine Posa
- Thea Posch, CMT, CCST
- Positive Regard Psychotherapy PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.