NPIMap

Individual provider Active NPI

Amanda Michelle Bonvicino, MD

  • Cytopathology Physician
  • Highlands Ranch, CO
National Provider Identifier
1861685067
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cytopathology PhysicianTaxonomy code 207ZC0500X
License
CDRH.0056687 Issued in CO
Practice address
1500 Park Central Dr
Highlands Ranch, CO 80129-6688
Phone
(720) 848-0000
NPI assigned
Aug 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X CDRH.0056687 CO Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X M8544 TX

Addresses

Primary practice location

1500 Park Central Dr
Highlands Ranch, CO 80129-6688

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

6116 E Warren Ave
Denver, CO 80222-5703
Phone (303) 512-2255

Other identifiers 1

IdentifierTypeStateIssuer
DR0056687OtherCOMEDICAL LICENSE

Other names 1

  • Amanda Michelle Reed Former name

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
I20161111000391 CO Practitioner - Pathology 8426337676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Texas Tech University Health Science Center School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8544TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Apr 19, 2021 Accepting new patients
University Physicians Incorporated CurrentSince Apr 19, 2021 Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

1500 Park Central Dr
Littleton, CO 80129
Phone (720) 516-1000

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1861685067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PARK CENTRAL DR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801296688",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6116 E Warren Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802225703",
            "country_code": "US",
            "telephone_number": "303-512-2255",
            "fax_number": "303-512-2268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONVICINO",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CO",
            "license": "CDRH.0056687",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "M8544",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "DR0056687",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "REED",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.