NPIMap

Individual provider Active NPI

Mariella Lyda Accame, PA

  • Physician Assistant
  • Lakewood, CO
National Provider Identifier
1629007141
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0003952 Issued in CO
Practice address
1746 Cole Blvd
Suite 150
Lakewood, CO 80401-3208
Phone
(303) 914-8800
Fax
(303) 716-3777
NPI assigned
Jun 30, 2006
Last updated
Jan 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103053 NC
Physician Assistant 363A00000X PA0003952 CO Primary

Addresses

Primary practice location

1746 Cole Blvd
Suite 150
Lakewood, CO 80401-3208

Mailing address

1746 Cole Blvd
Suite 150
Lakewood, CO 80401-3208
Phone (303) 914-8800

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
I20150102000656 CO Practitioner - Physician Assistant 3375641251 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
Diversified Radiology of Colorado IncGroup PAC ID 0143132316, 92 clinicians

Practice addresses (Care Compare)

1719 E 19TH Ave
Denver, CO 80218-1235
Phone (303) 914-8800

4567 E 9TH Ave
Denver, CO 80220-3908
Phone (303) 914-8800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.89 of 100Reported as group
Quality
75
Improvement activities
40
Cost
88.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0003952COMDPhysician Assistant
103053NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Radiology Associates PLLC Past Accepting new patients

Organizations & group practices 2

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 6

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1629007141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1746 COLE BLVD",
            "address_2": "SUITE 150",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013208",
            "telephone_number": "303-914-8800",
            "fax_number": "303-716-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1746 COLE BLVD",
            "address_2": "SUITE 150",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013208",
            "telephone_number": "303-914-8800",
            "fax_number": "303-716-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACCAME",
        "first_name": "MARIELLA",
        "middle_name": "LYDA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103053",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0003952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.