GARY ANTHONY SERRAVO PA-C NPI 1679922777

NPI Information

NPI: 1679922777
Provider Name: GARY ANTHONY SERRAVO, PA-C
Classification: Physician Assistant - 363AM0700X
Specialization: Medical
Entity Type: Individual
PECOS Registration: Yes
Address: 400 W 16TH ST
PUEBLO, CO
ZIP 81003
Phone: (719) 584-4306

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NPI Details

Gary Anthony Serravo, PA-C is a medical physician assistant in Pueblo, CO with 9 years of experience. Gary Anthony Serravo, PA-C NPI is 1679922777. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

400 W 16TH ST
PUEBLO, CO
ZIP 81003-745
Phone: (719) 584-4306
Fax: (719) 584-4861

The NPI 1679922777 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Emergency department visit for life threatening or functioning severity (HCPCS:99285)
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only (HCPCS:93010)
Emergency department visit for problem of high severity (HCPCS:99284)
Emergency department visit for problem of moderate severity (HCPCS:99283)

The enumeration date for this NPI number is 6/9/2016 and was last updated on 7/6/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA.0004647	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0004647	OTHER	COLORADO	PHYSICIAN ASSISTANT STATE CERTIFICATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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