MEDICARE: GENEVIEVE SPIESS BERARDUCCI PA

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	8582	CO

General Provider Information

NPI Number	:	1073203667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENEVIEVE SPIESS BERARDUCCI PA

Provider Business Mailing Address
First Line	:	1721 E 19TH AVE STE AND300
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1251
Country	:	US
Telephone Number	:	720-748-4800
Fax Number	:	720-748-4801

Provider Business Practice Location Address
First Line	:	1721 E 19TH AVE STE AND300
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1251
Country	:	US
Telephone Number	:	720-748-4800
Fax Number	:	720-748-4801

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

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	06/18/2026

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