Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Laurie Marguerite Mediavilla, PA-C

Individual provider Physician Assistant · NPI 1568513000

Laurie Marguerite Mediavilla, PA-C is a Physician Assistant in Colorado Springs, Colorado. Licensed in Colorado. Registered with an NPI since 2007.

Licensed in
CO
In the registry since
2007
Specialties on file
2
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

825 E Pikes Peak Ave
Colorado Springs, CO 80903-3624
Phone: (719) 776-8850
Fax: (719) 776-8854
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.0001028 (CO)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 1028 (CO)

Record details

NPI number1568513000
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 12, 2007
Last updated in NPPESDecember 16, 2019
Certification dateDecember 16, 2019

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