INTEGRATED DERMATOLOGY OF BOULDER CREEK, LLC – NPI #1568033066
Dermatology

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

INTEGRATED DERMATOLOGY OF BOULDER CREEK, LLC is a dermatologist located in SUPERIOR, CO. NPPES has assigned the NPI number 1568033066 to INTEGRATED DERMATOLOGY OF BOULDER CREEK, LLC on July 06, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207N00000X from the Health Care Provider Taxonomy code set, which is classified as Dermatology.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for INTEGRATED DERMATOLOGY OF BOULDER CREEK, LLC below.

NPI Profile for
INTEGRATED DERMATOLOGY OF BOULDER CREEK, LLC

NPI Number
1568033066
Enumeration Date

(about 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
INTEGRATED DERMATOLOGY OF BOULDER CREEK, LLC
Primary location
400 S MCCASLIN BLVD STE 100
SUPERIOR, CO 80027-9701
Phone: (303) 666-5261 Fax: (303) 604-6062
Mailing address
4700 EXCHANGE CT STE 110
BOCA RATON, FL 33431-4450
Phone: (561) 431-2821 Fax:
Organization Subpart
No
Authorized Official
DAVID FUENTES
AUTHORIZED
Phone: (561) 314-2000
Updated
Certification Date
Jul 06, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for INTEGRATED DERMATOLOGY OF BOULDER CREEK, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDCO9000168857
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207N00000X
- Dermatology (Primary)
363A00000X
- Physician Assistant
207ND0101X
- Dermatology / MOHS-Micrographic Surgery

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.