Individual provider Active NPI

Gavyn Eugene Prsha

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1831865914
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0019634 Issued in CO
Practice address
4740 Pearl Pkwy Ste 200
Boulder, CO 80301-3080
Phone
(303) 449-2730
NPI assigned
Aug 19, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X 2021024889 MO
Physical Therapist 225100000X PTL.0019634 CO Primary

Addresses

Primary practice location

4740 Pearl Pkwy Ste 200
Boulder, CO 80301-3080

Mailing address

4740 Pearl Pkwy Ste 200
Boulder, CO 80301-3080

Other practice location 1

2 Harbor Bend Ct Ste 102
Lake Saint Louis, MO 63367-1480
Phone (636) 695-2070

Other practice location 2

6240 S Main St Ste 230
Aurora, CO 80016-5377
Phone (303) 627-5735

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409004859 CO Practitioner - Physical Therapist in Private Practice 1759729700 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Luna Care Physical Therapy LLCGroup PAC ID 7517363617, 210 clinicians

Practice addresses (Care Compare)

Denver, CO 80246
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0019634COMDPhysical Therapist
2021024889MOMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Multi-Specialty CurrentSince Jun 28, 2024 Accepting new patients
Bouldercentre for Orthopedics PC Multi-Specialty CurrentSince Jul 22, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC Multi-Specialty Current Accepting new patients
Mountain View Pain Center Multi-Specialty CurrentSince Feb 28, 2024 Accepting new patients
Bouldercentre for Orthopedics Multi-Specialty CurrentSince Jul 22, 2024 Accepting new patients
Colorado Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jun 28, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC Multi-Specialty CurrentSince Jun 28, 2024 Accepting new patients

Locations

6240 S Main St
Ste 230
Aurora, CO 80016
Phone (303) 627-5735

4740 Pearl Pkwy
Ste 200
Boulder, CO 80301

500 Eldorado Blvd
Bldg 4
Broomfield, CO 80021
Phone (303) 812-4790

1185 State Highway 7
Ste 200
Broomfield, CO 80023

501 S Cherry St
Fl 11
Denver, CO 80246
Phone (309) 530-8782

5445 Dtc Pkwy
Ste 1130
Greenwood Village, CO 80111

5920 S Estes St
Ste 220
Littleton, CO 80123
Phone (303) 221-1569

8550 W 38th Ave
Ste 100
Wheat Ridge, CO 80033
Phone (303) 467-4100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3497/brand/1/csg/21/fhir/r4

Organizations & group practices 7

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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1831865914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 PEARL PKWY STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 PEARL PKWY STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013080",
            "telephone_number": "303-449-2730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Harbor Bend Ct Ste 102",
            "address_purpose": "LOCATION",
            "city": "Lake Saint Louis",
            "state": "MO",
            "postal_code": "633671480",
            "country_code": "US",
            "telephone_number": "636-695-2070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6240 S Main St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800165377",
            "country_code": "US",
            "telephone_number": "303-627-5735",
            "fax_number": "720-925-5897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRSHA",
        "first_name": "GAVYN",
        "middle_name": "EUGENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-19",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2021024889",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0019634",
            "primary": true
        }
    ],
    "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 Mar 7, 2025; 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.