Individual provider Active NPI

Nicco Buffolino, MD

  • General Practice Physician
  • Aurora, CO
National Provider Identifier
1982280855
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
DR.0069224 Issued in CO
Practice address
12631 E 17TH Ave Ste B177
Aurora, CO 80045-2527
Phone
(303) 724-1784
NPI assigned
Mar 22, 2021
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X DR.0069224 CO Primary

Addresses

Primary practice location

12631 E 17TH Ave Ste B177
Aurora, CO 80045-2527

Mailing address

12631 E 17TH Ave Ste B177
Aurora, CO 80045-2527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, OR, TX, CO4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20230814000118 NE Practitioner - General Practice 9234530932 Reassigns benefits to 1 organization
I20240109004821 OR Practitioner - General Practice 9234530932 Reassigns benefits to 1 organization
I20240116001179 TX Practitioner - General Practice 9234530932 Reassigns benefits to 1 organization
I20240806003906 CO Practitioner - General Practice 9234530932 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Aug 1, 2023 Accepting new patients

Locations

7700 E Arapahoe Rd
Ste 220
Centennial, CO 80112
Phone (303) 285-1148

1299 Farnam St
Ste 300
Omaha, NE 68102
Phone (402) 347-4191

780 Commercial St SE
Ste 100
Salem, OR 97301
Phone (469) 466-7037

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Organizations & group practices 1

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1982280855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12631 E 17TH AVE STE B177",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12631 E 17TH AVE STE B177",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452527",
            "telephone_number": "303-724-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFFOLINO",
        "first_name": "NICCO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "DR.0069224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.