Individual provider Active NPI

Deborah M Nuccio, PA

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1073657870
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
190 Issued in CO
Practice address
2045 Franklin St
Denver, CO 80205-5437
Phone
(303) 338-4545
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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 190 CO Primary

Addresses

Primary practice location

2045 Franklin St
Denver, CO 80205-5437

Mailing address

2045 Franklin St
Denver, CO 80205-5437
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
003610OtherCOKAISER-COMMERICAL NUMBER
09058338MedicaidCO

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
I20080626000285 CO Practitioner - Physician Assistant 3375615990 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190COMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Front Range, Inc. CurrentSince Jan 7, 2019 Accepting new patients

Locations

3210 Lutheran Pkwy
Wheat Ridge, CO 80033
Phone (303) 425-8000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1073657870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 FRANKLIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055437",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 FRANKLIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055437",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCCIO",
        "first_name": "DEBORAH",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERICAL NUMBER",
            "identifier": "003610",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09058338",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.