Individual provider Active NPI

Gretchen Berrios-Siervo, PSY.D.

  • Clinical Neuropsychologist
  • Aurora, CO
National Provider Identifier
1477809770
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
13123 E 16TH Ave
Box155
Aurora, CO 80045-7106
Phone
(720) 777-5513
NPI assigned
Jul 24, 2012
Last updated
Jul 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU Primary

Addresses

Primary practice location

13123 E 16TH Ave
Box155
Aurora, CO 80045-7106

Mailing address

PO Box 881
Quechee, VT 05059-0881
Phone (786) 295-3609

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
I20130206000148 CO Practitioner - Clinical Psychologist 6608020342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Colorado Current Accepting new patients
University Physicians Incorporated CurrentSince Apr 1, 2020 Accepting new patients

Locations

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

13123 E 16th Ave
#155
Aurora, CO 80045
Phone (509) 593-5235

13123 E 16th Ave
#B155
Aurora, CO 80045
Phone (720) 777-2704

Interoperability endpoints

  • Direct secure messaging: gberriossiervo45612@direct.childrenscolorado.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1477809770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 881",
            "city": "QUECHEE",
            "state": "VT",
            "postal_code": "050590881",
            "telephone_number": "786-295-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "address_2": "BOX155",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRIOS-SIERVO",
        "first_name": "GRETCHEN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.