Individual provider Active NPI

Rostislav Pavlik, M.D.

  • Anesthesiology Physician
  • Fort Collins, CO
National Provider Identifier
1558495986
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
44649 Issued in CO
Practice address
1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone
(970) 224-2985
Fax
(970) 472-9381
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA08128500 NJ
Anesthesiology Physician 207L00000X 35406 AZ
Anesthesiology Physician 207L00000X A96373 CA
Anesthesiology Physician 207L00000X 238208-1 NY
Anesthesiology Physician 207L00000X 8281A WY
Anesthesiology Physician 207L00000X 44649 CO Primary

Addresses

Primary practice location

1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000

Mailing address

1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone (970) 224-2985

Other practice location 1

2400 S Avenue A
Yuma, AZ 85364-7170
Phone (928) 344-2000

Other identifiers 1

IdentifierTypeStateIssuer
08871337MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY, AZ3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20070620000655 CO Practitioner - Anesthesiology 4486750965 Reassigns benefits to 5 organizations
I20120829000387 WY Practitioner - Anesthesiology 4486750965 Reassigns benefits to 1 organization
I20241218002377 AZ Practitioner - Anesthesiology 4486750965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians
Boulder Valley Anesthesiology, PLLCGroup PAC ID 7113830993, 61 clinicians

Practice addresses (Care Compare)

1750 E Ken Pratt Blvd
Uchealth
Longmont, CO 80504-5311
Phone (970) 237-7848

1760 E Ken Pratt Blvd
Longmont, CO 80504-5311

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44649COMDAnesthesiology Physician
238208-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain State Anesthesia Providers Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Anesthesiology Current Accepting new patients
Rocky Mountain State Anesthesia Providers Anesthesiology Current Accepting new patients
Rocky Mountain State Anesthesia Providers Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Yuma Regional Medical Center CurrentSince Dec 9, 2024 Accepting new patients
Boulder Valley Anesthesiology, PLLC Anesthesiology CurrentSince Feb 15, 2017 Accepting new patients
Anesthesiology Consultants of Cheyenne LLC Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
Sterling Anesthesia Associates LLC Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
Longmont Anesthesia Associates, PLLC Anesthesiology Past Accepting new patients
Northern Colorado Anesthesia Professionals PLLC Anesthesiology Past Accepting new patients
Redwood Anesthesia Services, a Medical Corporation Anesthesiology Past Accepting new patients
Outpatient Anesthesia Associates, LLC Past Accepting new patients
Clinical Colleagues LLC Anesthesiology Past Accepting new patients

Locations

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

1100 Balsam Ave
Boulder, CO 80304
Phone (303) 415-7000

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2030 Mountain View Ave
Longmont, CO 80501
Phone (303) 682-0375

1610 Dry Creek Dr
Longmont, CO 80503
Phone (720) 494-4750

2030 Mountain View Ave
Ste 100
Longmont, CO 80501
Phone (303) 682-0375

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

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

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

10170 Church Ranch Way
Westminster, CO 80021
Phone (303) 328-3400

2301 House Ave
Ste 200
Cheyenne, WY 82001
Phone (307) 421-8786

324 E 23Rd St
Cheyenne, WY 82001
Phone (307) 634-2273

214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 9

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1558495986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985",
            "fax_number": "970-472-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985",
            "fax_number": "970-472-9381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S Avenue A",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853647170",
            "country_code": "US",
            "telephone_number": "928-344-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVLIK",
        "first_name": "ROSTISLAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA08128500",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "35406",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A96373",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "238208-1",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WY",
            "license": "8281A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "44649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08871337",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.