Individual provider Active NPI

Paula M Dionisio, M.D.

  • Gastroenterology Physician
  • Pueblo, CO
National Provider Identifier
1669457263
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
47552 Issued in CO
Practice address
1600 N Grand Ave
Suite 150
Pueblo, CO 81003-2749
Phone
(719) 595-7680
Fax
(719) 595-7687
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 33326 AZ
Gastroenterology Physician 207RG0100X 47552 CO Primary

Addresses

Primary practice location

1600 N Grand Ave
Suite 150
Pueblo, CO 81003-2749

Mailing address

PO Box 560825
Denver, CO 80256-0825
Phone (719) 595-7580

Other identifiers 1

IdentifierTypeStateIssuer
07536011MedicaidCO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090821000081 CO Practitioner - GastroenterologyPractitioner - Cardiac Electrophysiology 6305990615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Cardiac Electrophysiology
Education
Georgetown University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

109 Latigo LN
Suite E
Canon City, CO 81212-8113
Phone (719) 562-2900

1600 N Grand Ave
Suite 310
Pueblo, CO 81003-2729
Phone (719) 595-7680

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020
  • Mt San Rafael Hospital Hospital, Trinidad, CO, CCN 061321
  • Arkansas Valley Regional Medical Center Hospital, Lajuna, CO, CCN 061336

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy74
Upper gastrointestinal (GI) endoscopy for acid reflux108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33326AZMDGastroenterology Physician
47552COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Rocky Mountain Cancer Centers LLP PastSince Aug 1, 2021 Accepting new patients
Digestive Health Associates Professional Corporation PastSince Mar 13, 2013 Accepting new patients

Locations

109 Latigo Ln
Ste E
Canon City, CO 81212
Phone (719) 562-2900

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1600 N Grand Ave
Ste 150
Pueblo, CO 81003
Phone (719) 595-7680

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

1600 N Grand Ave
Ste 310
Pueblo, CO 81003
Phone (719) 542-0072

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1669457263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560825",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802560825",
            "telephone_number": "719-595-7580",
            "fax_number": "719-545-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 150",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032749",
            "telephone_number": "719-595-7680",
            "fax_number": "719-595-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIONISIO",
        "first_name": "PAULA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "33326",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "47552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07536011",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.