Individual provider Active NPI

Michelle Gravalos

  • Family Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1740652833
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0001030 Issued in CO
Practice address
1080 S Sable Blvd
Aurora, CO 80012-3796
Phone
(303) 552-9577
NPI assigned
Oct 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0001030 CO Primary

Addresses

Primary practice location

1080 S Sable Blvd
Aurora, CO 80012-3796

Mailing address

1080 S Sable Blvd
Aurora, CO 80012-3796
Phone (303) 552-9577

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
I20180523003085 CO Practitioner - Nurse Practitioner 0143520551 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0001030COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Professional Services of Colorado PC CurrentSince Sep 1, 2025 Accepting new patients
Iora Health Massachusetts, P.C. Past Accepting new patients
Iora Health, LLC Past Accepting new patients

Locations

5017 W 64th Ave
Arvada, CO 80003
Phone (303) 970-2334

797 Peoria St
Ste E
Aurora, CO 80011
Phone (720) 914-8297

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1740652833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 S SABLE BLVD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123796",
            "telephone_number": "303-552-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 S SABLE BLVD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123796",
            "telephone_number": "303-552-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVALOS",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0001030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.