Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gary Anthony Serravo, PA-C

Individual provider Medical Physician Assistant · NPI 1679922777

Gary Anthony Serravo, PA-C is a Physician Assistant in Pueblo, Colorado. Qualified in 2016, 10 years ago. Practices with Stationmd Professional Corporation, a 62-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California, Colorado and New Jersey.

Years since qualifying
10
Licensed in
CA, CO, NJ
In the registry since
2016
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

400 W 16th St
Pueblo, CO 81003-2745
Phone: (719) 584-4306
Fax: (719) 584-4861
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2740 Fulton Ave Ste 220, Sacramento, CA 95821-5186 — (877) 782-8637

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA.0004647 (CO)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 25MP00842600 (NJ)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 65676 (CA)

Record details

NPI number1679922777
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 9, 2016
Last updated in NPPESMay 18, 2026
Certification dateMay 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Stationmd Professional Corporation — 62 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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