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PORTERCARE ADVENTIST HEALTH SYSTEM
NPI 1417821752
Pain Medicine - Interventional Pain Medicine in Lakewood, CO

Active since September 30, 2025
12596 W BAYAUD AVE STE 100, LAKEWOOD, CO 80228(720) 638-7500(720) 812-5134 Get Directions Write a Review

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Portercare Adventist Health System NPPES

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

PORTERCARE ADVENTIST HEALTH SYSTEM (NPI 1417821752), doing business as Neurosurgery One Interventional Pain Lakewood, is a healthcare organization registered as an interventional pain medicine in Lakewood, Colorado and active in the NPI registry since September 2025. The organization lists Jason Tacha, Coo, as its authorized official.

NPPES Registry Identity

NPI1417821752
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NamePORTERCARE ADVENTIST HEALTH SYSTEM
Location Address12596 W BAYAUD AVE STE 100Lakewood, CO 80228-2035
Mailing AddressPo Box 713425Chicago, IL 60677-4325 · (800) 953-0104
Phone(720) 638-7500
Fax(720) 812-5134
Organization SubpartNo
Authorized OfficialJason TachaCoo · (303) 304-7752
Enumeration DateSeptember 30, 2025
NPPES CertifiedSeptember 30, 2025
✔ NPI 1417821752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
Definition
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
12596 W BAYAUD AVE STE 100, Lakewood, CO 80228
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Other Names 1

Doing Business AsNeurosurgery One Interventional Pain Lakewood

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Portercare Adventist Health System is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

733

Medicare enrollment records show 733 clinicians reassign Medicare billing to Portercare Adventist Health System, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 155 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 45

Nurse Practitioner159
Family Practice83
Internal Medicine77
Obstetrics/Gynecology69
Hospitalist47
Orthopedic Surgery36
Gastroenterology25
Mental Health Counselor20
37 other specialties217

Nearest to this location (20)

See all 733
Joshua Beckman, MD
Neurosurgery
NPI 1558686113
12596 W BAYAUD AVE STE 100
Lakewood, CO 80228
(720) 638-7500
✔ PECOS✔ Accepts MedicareSame address
Tessa Henderson, NP
Nurse Practitioner
NPI 1033558101
12596 W BAYAUD AVE STE 100
Lakewood, CO 80228
(303) 649-3050
✔ PECOS✔ Accepts MedicareSame address
Randall Allison, M.D.
Neurosurgery
NPI 1245627835
11750 W 2ND PL STE 255
Lakewood, CO 80228
(720) 321-8040
✔ PECOS✔ Accepts Medicare0.4 mi
Elizabeth Ceilley, M.D.
Radiation Oncology
NPI 1629016100
11750 W 2ND PL STE 150
Lakewood, CO 80228
(720) 321-8800
✔ PECOS✔ Accepts Medicare0.4 mi
Kellie Costanza, FNP
Nurse Practitioner
NPI 1689229825
11750 W 2ND PL STE 255
Lakewood, CO 80228
(720) 321-8040
✔ PECOS✔ Accepts Medicare0.4 mi
Laura Friedlander, MD
Neurology
NPI 1578852042
11750 W 2ND PL STE 255
Lakewood, CO 80228
(720) 321-8040
✔ PECOS✔ Accepts Medicare0.4 mi
Lloyd Mobley, M.D.
Neurosurgery
NPI 1962501932
11750 W 2ND PL STE 255
Lakewood, CO 80228
(720) 638-7500
✔ PECOS✔ Accepts Medicare0.4 mi
John Hudson, MD
Neurosurgery
NPI 1184634537
11750 W 2ND PL STE 255
Lakewood, CO 80228
(720) 321-8040
✔ PECOS✔ Accepts Medicare0.6 mi
Kendell Bennion
Internal Medicine
NPI 1972755064
11600 W 2ND PL
Lakewood, CO 80228
(720) 321-0000
✔ PECOS✔ Accepts Medicare0.6 mi
Dawn Eldridge, ANP
Nurse Practitioner
NPI 1225258502
11700 W 2ND PL STE 255
Lakewood, CO 80228
(303) 661-4100
✔ PECOS✔ Accepts Medicare0.6 mi
Monique Fox, MD
Diagnostic Radiology
NPI 1952433641
11700 W 2ND PL STE 100
Lakewood, CO 80228
(720) 321-8230
✔ PECOS✔ Accepts Medicare0.6 mi
Sujata Fretz, MD
Hospitalist
NPI 1093821795
11600 W 2ND PL
Lakewood, CO 80228
(720) 321-0000
✔ PECOS✔ Accepts Medicare0.6 mi
Marchyarn Mahathanaruk, D.O.
Anesthesiology
NPI 1265674287
11700 W 2ND PL STE 225
Lakewood, CO 80228
(303) 661-4100
✔ PECOS✔ Accepts Medicare0.6 mi
Robert Mcclay, MD
Hospitalist
NPI 1972570554
11600 W 2ND PL
Lakewood, CO 80228
(720) 321-0000
✔ PECOS✔ Accepts Medicare0.6 mi
Eamonn Quinn, MD
Diagnostic Radiology
NPI 1104115732
11700 W 2ND PL
Lakewood, CO 80228
(720) 321-8230
✔ PECOS✔ Accepts Medicare0.6 mi
Tracy Stiller, MD
Hospitalist
NPI 1467424259
11650 W 2ND PL
Lakewood, CO 80228
(720) 321-5200
✔ PECOS✔ Accepts Medicare0.6 mi
Eric Yoder, MD
Internal Medicine
NPI 1205270733
11600 W 2ND PL
Lakewood, CO 80228
(720) 321-0000
✔ PECOS✔ Accepts Medicare0.6 mi
Ashley Mckillop, NP
Nurse Practitioner
NPI 1851885446
355 UNION BLVD STE 200
Lakewood, CO 80228
(303) 463-3900
✔ PECOS✔ Accepts Medicare0.7 mi
Kathryn Dunham Coughlin, PSYD
Clinical Psychologist
NPI 1972861532
11750 W 2ND PL
Lakewood, CO 80228
(720) 321-8040
✔ PECOS✔ Accepts Medicare1.1 mi
Theodore Ning, MD
Urology
NPI 1720172059
400 INDIANA ST SUITE 300
Golden, CO 80401
(303) 885-2550
✔ PECOS✔ Accepts Medicare1.4 mi
See all 733 clinicians

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

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 Portercare Adventist Health System's NPI number?

The NPI number for Portercare Adventist Health System is 1417821752. It was assigned to this organization in the NPPES registry on September 30, 2025. The provider is doing business as Neurosurgery One Interventional Pain Lakewood.

Where is Portercare Adventist Health System located?

Portercare Adventist Health System is located at 12596 W Bayaud Ave Ste 100, Lakewood, CO 80228. The listed phone number is (720) 638-7500.

What is Portercare Adventist Health System's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Portercare Adventist Health System enrolled in Medicare?

Yes. Portercare Adventist Health System is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Portercare Adventist Health System?

According to the CMS Revalidation Reassignment List (October 2026 release), 733 clinicians in 45 Medicare specialties reassign their Medicare billing to Portercare Adventist Health System. A 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 the clinician's services. The largest specialties are Nurse Practitioner (159), Family Practice (83) and Internal Medicine (77). Of these, 2 practice at this address and 155 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Portercare Adventist Health System was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.