Individual provider Active NPI

Paulina Segovia, RDN

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1326647934
Registry record updated Dec 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006537 Issued in CO
Practice address
5075 Lincoln St
Denver, CO 80216-2015
Phone
(303) 458-5302
NPI assigned
Oct 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA.0006537 CO Primary

Addresses

Primary practice location

5075 Lincoln St
Denver, CO 80216-2015

Mailing address

3885 Tennyson St Apt 525
Denver, CO 80212-2293
Phone (317) 748-7502

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
I20221115002601 CO Practitioner - Physician Assistant 5395113872 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0006537COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica Tepeyac, Inc Past Accepting new patients
La Clinica Tepeyac, Inc Multi-Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: paulina.segovia@tepeyac.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1326647934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3885 TENNYSON ST APT 525",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802122293",
            "telephone_number": "317-748-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 LINCOLN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802162015",
            "telephone_number": "303-458-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGOVIA",
        "first_name": "PAULINA",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.