Individual provider Active NPI

Amanda M Paolucci

  • Adult Health Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1083592158
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN.10000844-NP Issued in CO
Practice address
2113 Walnut St Apt 8
Boulder, CO 80302-4560
Phone
(248) 495-1609
NPI assigned
Aug 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APN.10000844-NP CO Primary

Addresses

Primary practice location

2113 Walnut St Apt 8
Boulder, CO 80302-4560

Mailing address

2113 Walnut St Apt 8
Boulder, CO 80302-4560

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
I20251027002343 CO Practitioner - Nurse Practitioner 2961991435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Term Care and Rehab ConsultantsGroup PAC ID 5294733861, 58 clinicians

Practice addresses (Care Compare)

4800 Tabor St
Wheat Ridge, CO 80033-2112
Phone (303) 421-4161

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.10000844-NPCOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Long Term Care and Rehab Consultants CurrentSince Oct 6, 2025 Accepting new patients

Locations

12650 W 64th Ave
Unit E501
Arvada, CO 80004
Phone (303) 431-4127

7481 Knox Pl
Westminster, CO 80030
Phone (303) 238-7505

4800 Tabor St
Wheat Ridge, CO 80033
Phone (303) 421-4161

Organizations & group practices 1

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1083592158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 WALNUT ST APT 8",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2113 WALNUT ST APT 8",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024560",
            "telephone_number": "248-495-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLUCCI",
        "first_name": "AMANDA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.10000844-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.