Organization Active NPI

Regenerative and Wellness Medicine P.C.

  • Internal Medicine Physician
  • Canon City, CO
National Provider Identifier
1659138337
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
REGENERATIVE AND WELLNESS MEDICINE P.C.
Practice address
609 Royal Gorge Blvd
Canon City, CO 81212-3750
Phone
(917) 717-4643
Fax
(917) 324-2154
NPI assigned
Feb 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Anton Sabiev, MDNPI 1871042440
Title
Physician
Phone
(917) 717-4643

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

609 Royal Gorge Blvd
Canon City, CO 81212-3750

Mailing address

609 Royal Gorge Blvd
Canon City, CO 81212-3750
Phone (917) 717-4643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260227001735 CO Part B Supplier - Clinic/Group Practice 0042791964 Receives reassigned benefits from 1 practitioner
Practice locations: Canon City, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2339850Regenerative and Wellness Medicine PC609 Royal Gorge Blvd, Canon City, CO 81212Certificate of waiverMar 8, 2028

National Provider Directory

National Provider Directory

Locations

609 Royal Gorge Blvd
Canon City, CO 81212
Phone (917) 717-4643

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1659138337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 ROYAL GORGE BLVD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123750",
            "telephone_number": "917-717-4643",
            "fax_number": "917-924-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 ROYAL GORGE BLVD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123750",
            "telephone_number": "917-717-4643",
            "fax_number": "917-324-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE AND WELLNESS MEDICINE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-29",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "SABIEV",
        "authorized_official_first_name": "ANTON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "917-717-4643",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.