NPIMap

Organization Active NPI

Elevation Medical, Inc.

  • General Practice Physician
  • Fort Collins, CO
National Provider Identifier
1639549215
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ELEVATION MEDICAL, INC.
Practice address
4745 Boardwalk Dr Unit C1
Fort Collins, CO 80525-3769
Phone
(970) 207-4066
Fax
(970) 225-1392
NPI assigned
Sep 25, 2015
Last updated
Sep 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Authorized official

Name
Michael PustilnikNPI 1609861335
Title
Partner
Phone
(970) 207-4066

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

4745 Boardwalk Dr Unit C1
Fort Collins, CO 80525-3769

Mailing address

4745 Boardwalk Dr Unit C1
Fort Collins, CO 80525-3769
Phone (970) 207-4066

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1639549215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 BOARDWALK DR UNIT C1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253769",
            "telephone_number": "970-207-4066",
            "fax_number": "970-225-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 BOARDWALK DR UNIT C1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253769",
            "telephone_number": "970-207-4066",
            "fax_number": "970-225-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATION MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "PUSTILNIK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "970-207-4066"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.