MRS. CANDACE LILLIAN DIREZZA PAC NPI 1942251228

NPI Information

NPI: 1942251228
Provider Name: MRS. CANDACE LILLIAN DIREZZA, PAC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
3555 LUTHERAN PKWY STE 200
WHEAT RIDGE, CO
ZIP 80033
Phone: (720) 284-3700
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MRS. Candace Lillian Direzza, PAC is a medical physician assistant in Wheat Ridge, CO. MRS. Candace Lillian Direzza, PAC NPI is 1942251228. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3555 LUTHERAN PKWY STE 200
WHEAT RIDGE, CO
ZIP 80033-027
Phone: (720) 284-3700

The NPI 1942251228 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 6/12/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	CO 1444	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	45274819	MEDICAID	COLORADO
2	C448168	MEDICARE PIN
3	P45409	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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