Individual provider Active NPI

Kaitlyn Rose Chavira

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1619713864
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0009671 Issued in CO
Practice address
595 Chapel Hills Dr Ste 325
Colorado Springs, CO 80920-1061
Phone
(719) 364-4120
Fax
(719) 364-4121
NPI assigned
Jul 8, 2024
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0009671 CO Primary

Addresses

Primary practice location

595 Chapel Hills Dr Ste 325
Colorado Springs, CO 80920-1061

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260428003064 CO Practitioner - Physician Assistant 8921575804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

595 Chapel Hills Dr
Colorado Springs, CO 80920-1022
Phone (719) 364-4141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA.0009671COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC PastSince May 26, 2026 Accepting new patients
Poudre Valley Medical Group, LLC PastSince May 26, 2026 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1619713864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 CHAPEL HILLS DR STE 325",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201061",
            "telephone_number": "719-364-4120",
            "fax_number": "719-364-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVIRA",
        "first_name": "KAITLYN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.