Tara J Edick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1653 Issued in CO

Practice address

777 Bannock St
MC 7782
Denver, CO 80204-4507

Phone

(303) 436-6000

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Community Care Clinic IncGroup PAC ID 8022284074, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tedick770540@direct.ochin.org

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.

• Summit Community Care Clinic, Inc.

  dba Elevated Community Health

  • Federally Qualified Health Center (FQHC)
  • Frisco, CO
  • NPI 1831219328
  Medicare reassignment Care Compare group NPD
• Summit Community Care Clinic, Inc.

  dba Elevated Community Health

  • Federally Qualified Health Center (FQHC)
  • Leadville, CO
  • NPI 1619522430
  NPD

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1972523850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 PEAK ONE DR",
            "address_2": "STE 260",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "80443",
            "telephone_number": "970-668-5584",
            "fax_number": "970-262-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "address_2": "MC 7782",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Peak One Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "CO",
            "postal_code": "804435948",
            "country_code": "US",
            "telephone_number": "970-668-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDICK",
        "first_name": "TARA",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Christine Edgell, PAC
• Laura P Edgerley-Gibb, MD
• Leigh Wilkes Edgerton
• Xavier Anthony Edgren, MD
• Edhealth, LLC.
• Katrina Emilie Edie
• Caroline Edler, MSS, LSW
• Edmond General Surgery LLC
• Edmond Intensivists LLC
• Edmond Spine and Orthopedics Services LLC

• Physician Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.