Individual provider Active NPI

Alyssa D Pensirikul, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Denver, CO
National Provider Identifier
1912133539
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
DR.0070057 Issued in CO
Practice address
DH Dept of Pediatric
777 Bannock Street
Denver, CO 80204
Phone
(303) 602-3300
NPI assigned
Jun 10, 2009
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X ME120819 FL
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 2023-02881 NC
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X DR.0070057 CO Primary

Addresses

Primary practice location

DH Dept of Pediatric
777 Bannock Street
Denver, CO 80204

Mailing address

1615 Country Club Prado
Coral Gables, FL 33134-2188

Other practice location 1

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

Other practice location 2

1150 NW 14th St
Miami, FL 33136-2137
Phone (305) 243-2421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NE, CO, SD, NC, MT, IA7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20140925001248 FL Practitioner - Neurology 4981844032 Reassigns benefits to 1 organization
I20230516000611 NE Practitioner - NeurologyPractitioner - Other (Physician) 4981844032
I20230613003252 CO Practitioner - Neurology 4981844032 Reassigns benefits to 2 organizations
I20231116001635 SD Practitioner - Neurology 4981844032 Reassigns benefits to 2 organizations
I20231207001036 NC Practitioner - Neurology 4981844032 Reassigns benefits to 1 organization
I20240103000186 MT Practitioner - Neurology 4981844032 Reassigns benefits to 1 organization
I20241119003754 IA Practitioner - Neurology 4981844032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WakemedGroup PAC ID 7315937612, 72 clinicians

Practice addresses (Care Compare)

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
Wakemed CurrentSince Nov 20, 2023 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Feb 17, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 23, 2023 Accepting new patients
Mercy Medical Center-Dubuque CurrentSince Feb 10, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 23, 2023 Accepting new patients
Wakemed CurrentSince Nov 20, 2023 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
Mercy Medical Center-Dubuque CurrentSince Feb 10, 2025 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1150 NW 14th St
Miami, FL 33136
Phone (305) 243-6165

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

250 Mercy Dr
Dubuque, IA 52001
Phone (563) 589-8000

120 Healthplex Way
Apex, NC 27502
Phone (919) 235-6525

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

400 US 70 Hwy E
Garner, NC 27529
Phone (919) 235-6400

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

8001 T W Alexander Dr
Raleigh, NC 27617
Phone (919) 350-0953

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

677 Cathedral Dr
Ste 200
Rapid City, SD 57701
Phone (605) 343-9224

Interoperability endpoints

  • Direct secure messaging: apensirikul296068@direct.dhha.org

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1912133539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 COUNTRY CLUB PRADO",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DH DEPT OF PEDIATRIC",
            "address_2": "777 BANNOCK STREET",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80204",
            "telephone_number": "303-602-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 New Bern Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 NW 14th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331362137",
            "country_code": "US",
            "telephone_number": "305-243-2421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENSIRIKUL",
        "first_name": "ALYSSA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME120819",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "2023-02881",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CO",
            "license": "DR.0070057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.