MEDICARE: ALEXANDRA CAPEZZUTO PHYSICIAN ASSISTANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	25MP00428700	NJ

General Provider Information

NPI Number	:	1053843961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA CAPEZZUTO PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	1818 N OGDEN ST STE 200
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1295
Country	:	US
Telephone Number	:	908-283-4056
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 N OGDEN ST STE 200
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1295
Country	:	US
Telephone Number	:	303-318-3434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2017
Last Update Date	:	02/19/2026

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Directions to “ ALEXANDRA CAPEZZUTO PHYSICIAN ASSISTANT” Practice Location

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