NPIMap

Individual provider Active NPI

Nicole Elizabeth Cucinella, PA-C

  • Family Medicine Physician
  • Westminster, CO
National Provider Identifier
1619223229
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3444 Issued in CO
Practice address
7625 W 92ND Ave
Westminster, CO 80021-4567
Phone
(303) 427-4075
Fax
(303) 427-4075
NPI assigned
Aug 1, 2012
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3444 CO Primary

Addresses

Primary practice location

7625 W 92ND Ave
Westminster, CO 80021-4567

Mailing address

7625W 92ND Ave
Westminster, CO 80021-4567
Phone (303) 427-4075

Other identifiers 1

IdentifierTypeStateIssuer
3444OtherCOCOLORADO PA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130711000353 CO Practitioner - Physician Assistant 2567602733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocky Mountain Primary Care , PCGroup PAC ID 3779471677, 38 clinicians

Practice addresses (Care Compare)

7625 W 92ND Ave
Westminster, CO 80021-4567
Phone (303) 650-3427

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Physicians - RMPC LLC Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
Todd Dextradeur MD PC PastSince Sep 1, 2020 Accepting new patients

Locations

5730 Ward Rd
Ste 102
Arvada, CO 80002
Phone (303) 422-6331

8585 W 14th Ave
Ste B-2
Lakewood, CO 80215
Phone (303) 238-1201

3520 W 92nd Ave
Ste 104
Westminster, CO 80031
Phone (303) 429-6600

7625 W 92nd Ave
Westminster, CO 80021
Phone (303) 252-7790

Interoperability endpoints

  • Direct secure messaging: nicole.cucinella.1@15135.direct.athenahealth.com

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1619223229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625W 92ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800214567",
            "telephone_number": "303-427-4075",
            "fax_number": "303-428-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 W 92ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800214567",
            "telephone_number": "303-427-4075",
            "fax_number": "303-427-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCINELLA",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "3444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO PA LICENSE",
            "identifier": "3444",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.