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MOUCHANTAT PLASTIC SURGERY PC
NPI 1255502753
Specialist in Wheat Ridge, CO

Active since March 12, 2008
3280 WADSWORTH BLVD, SUITE 100, WHEAT RIDGE, CO 80033(303) 232-8585(303) 232-3304 Get Directions Write a Review

NPPES record last updated: September 17, 2015. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mouchantat Plastic Surgery Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUCHANTAT PLASTIC SURGERY PC (NPI 1255502753), doing business as John M Pav Md Pc, is a healthcare organization registered as a specialist in Wheat Ridge, Colorado and active in the NPI registry since March 2008. The organization lists Richard A Mouchantat, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1255502753
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameMOUCHANTAT PLASTIC SURGERY PC
Location Address3280 WADSWORTH BLVD, SUITE 100Wheat Ridge, CO 80033-4640
Mailing Address3280 Wadsworth Blvd, Suite 100Wheat Ridge, CO 80033-4640 · (303) 232-8585 · Fax (303) 232-3304
Phone(303) 232-8585
Fax(303) 232-3304
Organization SubpartNo
Authorized OfficialRichard A MouchantatPhysician/owner · (303) 232-8585
Enumeration DateMarch 12, 2008
Last NPPES UpdateSeptember 17, 2015
✔ NPI 1255502753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3280 WADSWORTH BLVD, Wheat Ridge, CO 80033
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Other Names 1

Former Legal Business NameJohn M Pav Md Pc

Other Identifiers 1

Medicare PINCS4008CO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mouchantat Plastic Surgery Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateColoradoEnrollment IDO20040921001322Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mouchantat Plastic Surgery PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Richard Mouchantat, M.D.
Plastic and Reconstructive Surgery
NPI 1013937390
3280 WADSWORTH BLVD SUITE 100
Wheat Ridge, CO 80033
(303) 232-8585
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mouchantat Plastic Surgery PC's NPI number?

The NPI number for Mouchantat Plastic Surgery PC is 1255502753. It was assigned to this organization in the NPPES registry on March 12, 2008. The provider was formerly known as John M Pav MD PC.

Where is Mouchantat Plastic Surgery PC located?

Mouchantat Plastic Surgery PC is located at 3280 Wadsworth Blvd Suite 100, Wheat Ridge, CO 80033. The listed phone number is (303) 232-8585.

What is Mouchantat Plastic Surgery PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Mouchantat Plastic Surgery PC enrolled in Medicare?

Yes. Mouchantat Plastic Surgery PC is registered in the Medicare PECOS enrollment system.

When is Mouchantat Plastic Surgery PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Colorado, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Mouchantat Plastic Surgery PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Mouchantat Plastic Surgery PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mouchantat Plastic Surgery PC was last updated on September 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.