Individual provider Active NPI

Sunimae Anna Boccadoro, PTA

  • Physical Therapy Assistant
  • Aurora, CO
National Provider Identifier
1457698151
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
0012357 Issued in CO
Practice address
656 Dillon Way
Aurora, CO 80011-6803
Phone
(303) 344-0636
NPI assigned
Jan 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0012357 CO Primary

Addresses

Primary practice location

656 Dillon Way
Aurora, CO 80011-6803

Mailing address

10112 Quivas St
Thornton, CO 80260
Phone (720) 297-8018

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
0012357COMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1457698151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10112 QUIVAS ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80260",
            "telephone_number": "720-297-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 DILLON WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800116803",
            "telephone_number": "303-344-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCCADORO",
        "first_name": "SUNIMAE",
        "middle_name": "ANNA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "0012357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.