Individual provider Active NPI

Nicolette Angelica Picerno, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Denver, CO
National Provider Identifier
1851493936
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
38744 Issued in CO
Practice address
850 E Harvard Ave Ste 505
Denver, CO 80210-5078
Phone
(303) 744-1961
Fax
(303) 744-1110
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 38744 CO Primary

Addresses

Primary practice location

850 E Harvard Ave Ste 505
Denver, CO 80210-5078

Mailing address

850 E Harvard Ave
Ste #505
Denver, CO 80210-5073
Phone (303) 744-1961

Other practice location 1

2352 Meadows Blvd
Castle Rock, CO 80109-8406
Phone (303) 744-1961

Other practice location 2

9980 Park Meadows Dr Ste 200
Lone Tree, CO 80124-8406
Phone (303) 744-1961

Other identifiers 2

IdentifierTypeStateIssuer
30057779MedicaidCO
38744OtherCOSTATE

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
I20040302001088 CO Practitioner - OtolaryngologyPractitioner - Allergy/ImmunologyPractitioner - Plastic and Reconstructive Surgery 8325935513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology, Plastic and Reconstructive Surgery
Education
Hahnemann University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

850 E Harvard Ave
Suite 505
Denver, CO 80210-5078
Phone (303) 744-1961

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38744COMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates of Otolaryngology, P.C. CurrentSince Aug 1, 2000 Accepting new patients
Associates of Otolaryngology, P.C. Otolaryngology/Facial Plastic Surgery CurrentSince Aug 1, 2000 Accepting new patients

Locations

2352 Meadows Blvd
Ste 300
Castle Rock, CO 80109
Phone (303) 744-1961

850 E Harvard Ave
Ste 505
Denver, CO 80210
Phone (303) 744-1961

9980 Park Meadows Dr
Ste 200
Lone Tree, CO 80124
Phone (303) 607-4134

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1851493936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E HARVARD AVE",
            "address_2": "STE #505",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105073",
            "telephone_number": "303-744-1961",
            "fax_number": "303-744-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E HARVARD AVE STE 505",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105078",
            "telephone_number": "303-744-1961",
            "fax_number": "303-744-1110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2352 Meadows Blvd",
            "address_purpose": "LOCATION",
            "city": "Castle Rock",
            "state": "CO",
            "postal_code": "801098406",
            "country_code": "US",
            "telephone_number": "303-744-1961",
            "fax_number": "303-744-1154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9980 Park Meadows Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801248406",
            "country_code": "US",
            "telephone_number": "303-744-1961",
            "fax_number": "303-744-1154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICERNO",
        "first_name": "NICOLETTE",
        "middle_name": "ANGELICA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CO",
            "license": "38744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30057779",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "38744",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.