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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. NICHOLOS POOTHULLIL JOSEPH MD
NPI 1063107043
Student in an Organized Health Care Education/Training Program in Denver, CO

Active since April 06, 2023PECOS Enrolled
777 BANNOCK ST # MC0108, DENVER, CO 80204(303) 602-5193 Get Directions Write a Review

NPPES record last updated: October 19, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 8, 2026, Jul 28, 2026, Apr 6, 2023 (3 updates tracked since 2023).

About Dr. Nicholos Poothullil Joseph Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICHOLOS POOTHULLIL JOSEPH MD (NPI 1063107043) is an individual student in an organized health care education/training program in Denver, Colorado, licensed in Colorado (DR.0077856) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Harvard Medical School (2023).

NPPES Registry Identity

NPI1063107043
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. NICHOLOS POOTHULLIL JOSEPHCredential: MD
Location Address777 BANNOCK ST # MC0108Denver, CO 80204-4597
Mailing Address777 Bannock St # Mc0108Denver, CO 80204-4597 · (303) 602-5193
Phone(303) 602-5193
Sole ProprietorNo
Medical School CMSHarvard Medical SchoolGraduated 2023
Enumeration DateApril 6, 2023
Last NPPES UpdateOctober 19, 20263 updates tracked since enumeration
NPPES CertifiedOctober 19, 2026
✔ NPI 1063107043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CO · DR.0077856
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedEmergency MedicineTaxonomy 207P00000X · License DR.0077856 (CO)
777 BANNOCK ST # MC0108, Denver, CO 80204
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Other Names 1

Other Name (5)Nicky Joseph

Secondary Practice Locations 2

Location 110350 E Dakota AveDenver, CO 80247-1314 · Phone (303) 338-4545
Location 212505 East 16th Aveaurora, CO 80045 · Phone (720) 848-0000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholos Poothullil Joseph Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID345706396
PECOS Enrollment IDI20260729004417
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Nicholos Joseph reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Physicians Incorporated
1.4 mi
Physical Medicine & Rehabilitation
1224 5TH ST
Denver, CO 80204
  • Reassigned Medicare billing, Colorado enrollment
  • 4,283 clinicians in this Medicare group
NPI 1265689053 (303) 556-2040
Colorado Permanente Medical Group, P.C.
6.7 mi
Internal Medicine
10350 E DAKOTA AVE
Denver, CO 80247
  • Reassigned Medicare billing, Colorado enrollment
  • Medicare enrollment name: Colorado Permanente Medical Group PC
  • 1,715 clinicians in this Medicare group
NPI 1760599724 (303) 338-4545

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COURTNEY DIANE WHAM
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
MICHAEL AAMLI BERGAMINI
Emergency Medicine
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
HANNAH RILEY OBRIEN
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
ANNA DE SCHUTTER
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
DOMINIQUE ALEXIS WILLIAMS
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
MARY MARGARET RYAN MD
Emergency Medicine
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
TANNER MUGGLI MD
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
WILLIAM CANTY
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholos Joseph's NPI number?

The NPI number for Nicholos Joseph is 1063107043. It was assigned to this individual provider in the NPPES registry on April 6, 2023. The provider is also known as Nicky Joseph.

Where is Nicholos Joseph located?

Nicholos Joseph practices at 777 Bannock St # Mc0108, Denver, CO 80204. The listed phone number is (303) 602-5193.

What is Nicholos Joseph's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Nicholos Joseph enrolled in Medicare?

Yes. Nicholos Joseph is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nicholos Joseph's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicholos Joseph reassigns Medicare benefits to 2 organizations: University Physicians Incorporated (Denver, CO) and Colorado Permanente Medical Group, P.C. (Denver, CO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicholos Joseph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicholos Joseph was last updated on October 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.