Individual provider Active NPI

Dominique A. Verrecchia, PA

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1558335778
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1318 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4507
Phone
(303) 436-4200
Fax
(303) 436-4448
NPI assigned
Feb 14, 2006
Last updated
May 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1318 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4507

Mailing address

777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4200

Other practice location 1

2400 S Peoria St
#100
Aurora, CO 80014-5476
Phone (303) 306-4321

Other identifiers 1

IdentifierTypeStateIssuer
06403743MedicaidCO

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dverrecchia12173@direct.dhha.org Health Information Exchange (HIE)
Direct Messaging Address dverrecchia12173@direct.dhha.org Health Information Exchange (HIE)

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051014000224 CO Practitioner - Physician Assistant 8022033406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

777 Bannock St
Denver, CO 80204-4597

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1318COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince May 27, 2013 Accepting new patients
Denver Health and Hospital Authority CurrentSince May 27, 2013 Accepting new patients
Inpatient Consultants of Colorado, PC Physician Assistant Past Accepting new patients
Inpatient Consultants of Colorado PC Past Accepting new patients
Apex Emergency Group, Inc Past Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

Interoperability endpoints

  • Direct secure messaging: dverrecchia12173@direct.dhha.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1558335778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-4200",
            "fax_number": "303-436-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-436-4200",
            "fax_number": "303-436-4448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S Peoria St",
            "address_2": "#100",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800145476",
            "country_code": "US",
            "telephone_number": "303-306-4321",
            "fax_number": "303-306-4347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERRECCHIA",
        "first_name": "DOMINIQUE",
        "middle_name": "A.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06403743",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dverrecchia12173@direct.dhha.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dverrecchia12173@direct.dhha.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.