Individual provider Active NPI

Sydney Pantoja

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1407486335
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW09927862 Issued in CO
Practice address
1751 S 8TH St
Colorado Springs, CO 80905-1926
Phone
(719) 471-1816
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW09927862 CO Primary

Addresses

Primary practice location

1751 S 8TH St
Colorado Springs, CO 80905-1926

Mailing address

1751 S 8TH St
Colorado Springs, CO 80905-1926
Phone (719) 471-1816

Other practice location 1

944 E Rio Grande St
Colorado Springs, CO 80903-4561
Phone (719) 232-2914

Other identifiers 1

IdentifierTypeStateIssuer
9000200294MedicaidCO

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230506000095 CO Practitioner - Clinical Social Worker 9133584634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocksolid Care IncGroup PAC ID 0446625362, 5 clinicians

Practice addresses (Care Compare)

2116 Hollow Brook Dr
Suite 100
Colorado Springs, CO 80918-1443
Phone (719) 249-0984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW09927862COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rocksolid Care Inc. Clinical CurrentSince Jun 5, 2023 Accepting new patients
Rocksolid Care Inc. Clinical CurrentSince Jun 5, 2023 Accepting new patients

Locations

6985 Tutt Blvd
Ste 100
Colorado Springs, CO 80923
Phone (719) 332-4689

2116 Hollow Brook Dr
Ste 100
Colorado Springs, CO 80918
Phone (719) 249-0984

320 E Fontanero St
Ste 301
Colorado Springs, CO 80907
Phone (719) 624-0594

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": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1407486335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 S 8TH ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809051926",
            "telephone_number": "719-471-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 S 8TH ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809051926",
            "telephone_number": "719-471-1816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "944 E Rio Grande St",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809034561",
            "country_code": "US",
            "telephone_number": "719-232-2914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTOJA",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW09927862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000200294",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.