NPIMap

Individual provider Active NPI

Nicole Marie Garduno, P.A.-C

  • Surgical Physician Assistant
  • Aurora, CO
National Provider Identifier
1255755674
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0003742 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Feb 5, 2014
Last updated
Dec 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0003742 CO
Surgical Physician Assistant 363AS0400X 0003742 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

4567E 9TH Ave
Denver, CO 80220-3908
Phone (303) 320-7200

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
I20140423001948 CO Practitioner - Physician Assistant 0244463461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0003742COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Jan 1, 2020 Accepting new patients
University Physicians, Incorporated CurrentSince Jan 1, 2020 Accepting new patients
University Physicians Incorporated Physician Assistant Past Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1665 Aurora Ct
Aurora, CO 80045
Phone (720) 848-0300

4545 E 9th Ave
Ste 10
Denver, CO 80220
Phone (303) 320-2121

Organizations & group practices 3

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1255755674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4567E 9TH AVE",
            "address_purpose": "LOCATION",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203908",
            "country_code": "US",
            "telephone_number": "303-320-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDUNO",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0003742",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "0003742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.