Individual provider Active NPI

Jacy Gansz-Torres, FNP

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1184451429
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.1000251-NP Issued in CO
Practice address
1301 E 7TH St
Pueblo, CO 81001-3508
Phone
(719) 543-8711
NPI assigned
Sep 19, 2024
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 64130 NM
Family Nurse Practitioner 363LF0000X APN.1000251-NP CO Primary

Addresses

Primary practice location

1301 E 7TH St
Pueblo, CO 81001-3508

Mailing address

110 E Routt Ave
Pueblo, CO 81004-2117
Phone (719) 543-8711

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
I20241115004116 CO Practitioner - Nurse Practitioner 2365976065 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinidad Area Health AssociationGroup PAC ID 2769394055, shared by 2 NPIs, 28 clinicians

Practice addresses (Care Compare)

1301 E 7TH St
Pueblo, CO 81001-3508
Phone (719) 543-8711

400 Benedicta Ave
Suite a
Trinidad, CO 81082-2089
Phone (719) 846-2206

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64130NMMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Community Health Center Inc Federally Qualified Health Center (FQHC) CurrentSince Oct 15, 2024 Accepting new patients
Pueblo Community Health Center Inc Federally Qualified Health Center (FQHC) Current Accepting new patients
Pueblo Community Health Center Inc Federally Qualified Health Center (FQHC) CurrentSince Oct 15, 2024 Accepting new patients
Pueblo Community Health Center Inc. Federally Qualified Health Center (FQHC) Past Accepting new patients

Locations

110 E Routt Ave
Pueblo, CO 81004
Phone (719) 543-8718

1301 E 7th St
Pueblo, CO 81001
Phone (719) 476-0220

300 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

Interoperability endpoints

  • Direct secure messaging: jacy.gansztorres.p1@direct.pueblochc.nextgenshare.com

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

Hospital & facility affiliations 1

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": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1184451429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROUTT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042117",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E 7TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810013508",
            "telephone_number": "719-543-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSZ-TORRES",
        "first_name": "JACY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "64130",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.1000251-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.