Organization Active NPI

Caravita Health LLC

  • Health Service Clinic/Center
  • Boulder, CO
National Provider Identifier
1821876491
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
CARAVITA HEALTH LLC
Practice address
3065 Center Green Dr Ste 216
Boulder, CO 80301-2251
Phone
(720) 910-1410
NPI assigned
Sep 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Mario Rafael Anglada Cortes
Title
Ceo
Phone
(720) 761-1362

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

3065 Center Green Dr Ste 216
Boulder, CO 80301-2251

Mailing address

109 E 17TH St Ste 6178
Cheyenne, WY 82001-4543
Phone (720) 761-1362

National Provider Directory

National Provider Directory

Locations

3065 Center Green Dr
Ste 216
Boulder, CO 80301
Phone (720) 910-1410

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": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1821876491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E 17TH ST STE 6178",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014543",
            "telephone_number": "720-761-1362",
            "fax_number": "303-484-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 CENTER GREEN DR STE 216",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012251",
            "telephone_number": "720-910-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARAVITA HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "ANGLADA CORTES",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "RAFAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-761-1362"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.

Verify at the official NPI Registry.