NPIMap

Individual provider Active NPI

Leslie Ann Dabovich, MD

  • Family Medicine Physician
  • Pueblo, CO
National Provider Identifier
1225349202
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0052593 Issued in CO
Practice address
902 Lakeview Ave
Pueblo, CO 81004-3597
Phone
(719) 557-5855
Fax
(719) 557-5097
NPI assigned
Jun 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0052593 CO Primary

Addresses

Primary practice location

902 Lakeview Ave
Pueblo, CO 81004-3597

Mailing address

902 Lakeview Ave
Pueblo, CO 81004-3597
Phone (719) 557-5855

Other identifiers 1

IdentifierTypeStateIssuer
89324285MedicaidCO

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
I20130911000171 CO Practitioner - Family Practice 2466696554 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New Mexico School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

902 Lakeview Ave
Pueblo, CO 81004-3597
Phone (719) 557-5855

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Community Health Center Inc CurrentSince Nov 1, 2015 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 17, 2015 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 17, 2015 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Pueblo Community Health Center Inc CurrentSince Nov 1, 2015 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients

Locations

300 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

902 Lakeview Ave
Pueblo, CO 81004
Phone (719) 557-5855

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

110 E Routt Ave
Pueblo, CO 81004
Phone (719) 543-8718

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

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1225349202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 LAKEVIEW AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043597",
            "telephone_number": "719-557-5855",
            "fax_number": "719-557-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 LAKEVIEW AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043597",
            "telephone_number": "719-557-5855",
            "fax_number": "719-557-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABOVICH",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0052593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89324285",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.