Individual provider Active NPI

Diane M Scanzaroli, PA-C

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1104997519
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0002641 Issued in CO
Practice address
1532 Galena St
Suite 300
Aurora, CO 80010-2287
Phone
(303) 900-8639
Fax
(720) 204-5534
NPI assigned
Nov 10, 2006
Last updated
Feb 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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 0002641 CO Primary

Addresses

Primary practice location

1532 Galena St
Suite 300
Aurora, CO 80010-2287

Mailing address

1532 Galena St
Aurora, CO 80010-2287
Phone (303) 900-8639

Other identifiers 1

IdentifierTypeStateIssuer
44008392MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2641COMDProfessional Counselor
0002641COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ardas LLC Past Accepting new patients
University Physicians Healthcare Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1104997519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 GALENA ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800102287",
            "telephone_number": "303-900-8639",
            "fax_number": "720-204-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 GALENA ST",
            "address_2": "SUITE 300",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800102287",
            "telephone_number": "303-900-8639",
            "fax_number": "720-204-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANZAROLI",
        "first_name": "DIANE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0002641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44008392",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.