Paula Joy Passanisi IV

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1333 Iris Ave
Boulder, CO 80304-2226

Phone

(617) 501-2884

NPI assigned

Sep 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1548419625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3013 13TH STREET",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80304",
            "telephone_number": "617-501-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 IRIS AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042226",
            "telephone_number": "617-501-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSANISI",
        "first_name": "PAULA",
        "middle_name": "JOY",
        "name_suffix": "IV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Carole Pascoe
• Nicholas Stefan Pasic, M.D.
• Ian David Pasikov, M.A.
• Lauren Pass Erickson, MA, LPC
• Erin Pass, L.AC., DIPL. C.H.
• Carol Passarelli, PT, DPT
• Colleen Min Hee Passoth, LMSW
• Pat Guyton Pilates
• Joli Nicol Pate, LCSW
• Deepti Patel, MD

• Clinical Social Worker in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.