Active NPI
Ethan Dvorak
- Physical Therapist
- Englewood, CO
National Provider Identifier
1740090232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL.0020326
- Practice address
- 3401 S Lafayette St
Englewood, CO 80113-2926 - Phone
- (720) 838-2219
- NPI assigned
- Jan 8, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTL.0020326 | CO | Primary |
Addresses
Primary practice location
3401 S Lafayette St
Englewood, CO 80113-2926
Mailing address
3320 S Pearl St Unit B
Englewood, CO 80113-2884
Phone (970) 481-1876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0020326 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1740090232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3320 S PEARL ST UNIT B",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801132884",
"telephone_number": "970-481-1876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 S LAFAYETTE ST",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801132926",
"telephone_number": "720-838-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DVORAK",
"first_name": "ETHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-08",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL.0020326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.