Individual provider Active NPI

Jessika Siorai, LAC

  • Acupuncturist
  • Boulder, CO
National Provider Identifier
1457474116
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
002989-1 Issued in NY
Practice address
3445 Penrose PL Ste 240
Boulder, CO 80301-1877
Phone
(303) 351-5618
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 0002119 CO
Acupuncturist 171100000X 002989-1 NY Primary

Addresses

Primary practice location

3445 Penrose PL Ste 240
Boulder, CO 80301-1877

Mailing address

3445 Penrose PL Ste 240
Boulder, CO 80301-1877
Phone (303) 351-5618

Other names 1

  • Jessika Conde Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0002119COMDAcupuncturist
002989-1NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1457474116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 PENROSE PL STE 240",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011877",
            "telephone_number": "303-351-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 PENROSE PL STE 240",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011877",
            "telephone_number": "303-351-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIORAI",
        "first_name": "JESSIKA",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "0002119",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "002989-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIKA",
            "last_name": "CONDE",
            "credential": "LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.