Individual provider Active NPI

Brian Andrew Kacvinsky, PA-S

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1962001438
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1333 E 17TH Ave
Denver, CO 80218-1526
Phone
(720) 985-9595
NPI assigned
Oct 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CO Primary

Addresses

Primary practice location

1333 E 17TH Ave
Denver, CO 80218-1526

Mailing address

1333 E 17TH Ave
Denver, CO 80218-1526
Phone (720) 985-9595

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

NPI Registry JSON

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1962001438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 E 17TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181526",
            "telephone_number": "720-985-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 E 17TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181526",
            "telephone_number": "720-985-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACVINSKY",
        "first_name": "BRIAN",
        "middle_name": "ANDREW",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-25",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.