NPIMap

Individual provider Active NPI

Laura S Marinello, PA

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1093839730
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2206 Issued in CO
Practice address
1800 15TH St
Suite 310
Greeley, CO 80631-4500
Phone
(970) 392-0900
Fax
(970) 506-3796
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 2206 CO Primary

Addresses

Primary practice location

1800 15TH St
Suite 310
Greeley, CO 80631-4500

Mailing address

51 West 84TH Ave
Suite 210
Denver, CO 80260-4882
Phone (303) 427-1601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070913000925 CO Practitioner - Physician Assistant 0648364125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1800 15TH St
Greeley, CO 80631-4562

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

1900 Boise Ave
Loveland, CO 80538-5004

4700 Lady Moon Dr
Fort Collins, CO 80528-4426

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2206COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Feb 1, 2013 Accepting new patients
NCMC Specialty Clinic CurrentSince Jul 7, 2008 Accepting new patients
Rocky Mountain Gastroenterology Associates, PLLC CurrentSince Jan 16, 2007 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Feb 1, 2013 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients
North Denver Pulmonary & Critical Care PastSince Oct 20, 2008 Accepting new patients

Locations

1800 15th St
Ste 340
Greeley, CO 80631
Phone (970) 351-6044

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

1800 15th St
Ste 310
Greeley, CO 80631
Phone (970) 392-0900

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1900 Boise Ave
Ste 200
Loveland, CO 80538
Phone (970) 203-2120

10001 Washington St
Thornton, CO 80229
Phone (303) 252-0083

Organizations & group practices 6

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093839730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 WEST 84TH AVE",
            "address_2": "SUITE 210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802604882",
            "telephone_number": "303-427-1601",
            "fax_number": "303-426-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 15TH ST",
            "address_2": "SUITE 310",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806314500",
            "telephone_number": "970-392-0900",
            "fax_number": "970-506-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINELLO",
        "first_name": "LAURA",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.