Individual provider Active NPI

Devin Leah Staniar, PA

  • Physician Assistant
  • Pueblo, CO
National Provider Identifier
1972682714
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2258 Issued in CO
Practice address
212 W 13TH St
Pueblo, CO 81003-3754
Phone
(719) 696-9027
NPI assigned
Nov 3, 2006
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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 2258 CO Primary

Addresses

Primary practice location

212 W 13TH St
Pueblo, CO 81003-3754

Mailing address

212 W 13TH St
Pueblo, CO 81003-3754
Phone (719) 696-9027

Other practice location 1

2415 E Camelback Rd Ste 700
Phoenix, AZ 85016-4245
Phone (480) 690-9522

Other practice location 2

2033 Gateway Pl
San Jose, CA 95110-3709
Phone (657) 500-0634

Other identifiers 1

IdentifierTypeStateIssuer
96289201MedicaidCO

Other names 1

  • Devin Leah Flaherty Former name

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
I20110801000810 CO Order and Referring Only - Physician Assistant 2062519663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2258COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Healthcare LLC Past Accepting new patients
Bicycle Health Medical Group PA Past Accepting new patients
Elevate Healthcare LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1972682714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033754",
            "telephone_number": "719-696-9027",
            "fax_number": "719-582-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033754",
            "telephone_number": "719-696-9027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2415 E Camelback Rd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164245",
            "country_code": "US",
            "telephone_number": "480-690-9522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2033 Gateway Pl",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951103709",
            "country_code": "US",
            "telephone_number": "657-500-0634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANIAR",
        "first_name": "DEVIN",
        "middle_name": "LEAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96289201",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEVIN",
            "last_name": "FLAHERTY",
            "middle_name": "LEAH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.