Sara Elizabeth Shively, PA-C
Individual provider Active NPI Physician Assistant · Pagosa Springs, CO
NPI 1275768673 · NPPES record last updated Feb 11, 2026
Key facts
- NPI
- 1275768673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA.0003685 (CO)
- Practice address
- 52 Village Dr
Pagosa Springs, CO 81147-8368 - Phone
- (970) 264-2104
- NPI assigned
- May 29, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Durango Urgent Care LLC
Aztec Urgent Care, LLC
Practice addresses (Care Compare)
2577 Main Ave
Durango, CO 81301-5919
Phone (970) 247-8382
2930 E Main St
Farmington, NM 87402-7624
Phone (970) 505-2100
Hospital & facility affiliations
- Mercy Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CO, NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130618000086 | CO | Practitioner - Physician Assistant | 5799831178 | Reassigns benefits to 1 organization |
| I20160127002259 | NM | Practitioner - Physician Assistant | 5799831178 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2015-0097 | NM | MD | Physician Assistant |
| 11212 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Colorado Mental Health Center, Inc | Current |
Accepting new patients | |
| Southwest Colorado Mental Health Center Inc | Current |
Accepting new patients |
Locations
495 W 4th St
Dove Creek, CO 81324
Phone (970) 677-2291
1970 E 3rd Ave
Ste 1
Durango, CO 81301
Phone (970) 335-2288
27B Talisman Dr
Unit 3
Pagosa Springs, CO 81147
Phone (970) 372-0456
52 Village Dr
Pagosa Springs, CO 81147
Phone (970) 264-2104
Interoperability endpoints
- sshively93088@direct.phs.org
- sara.shively.p1@direct.ahs.nextgenshare.com
- sara.shively@66979158884356.direct.elationemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | VA | ||
| Physician Assistant | 363A00000X | PA2015-0097 | NM | |
| Physician Assistant | 363A00000X | PA.0003685 | CO | Yes |
Addresses
Primary practice location
52 Village Dr
Pagosa Springs, CO 81147-8368
Mailing address
PO Box 1328
Durango, CO 81302-1328
Phone (970) 335-2342
Other practice location 1
5901 Harper Dr NE
PMG Urgent Care
Albuquerque, NM 87109-3587
Phone (505) 823-8233
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16531779 | Medicaid | NM |
Other providers in Pagosa Springs, CO
- Sedona Wellness, LLC
- Selah Mountain Pharmacy LLC
- Angela Sewell
- David Scott Shaeffer
- Hillary Ann Shaw
- Sleep Apnea Solutions Colorado LLC
- Smart Mobility, Inc.
- Brian Shawn Smith
- Eric Michael Smith
- Gary Scott Smith
All providers in Pagosa Springs, CO · Physician Assistant in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.