NPIMap

Individual provider Active NPI

Anne-Lise Hultsch, M.D.

  • Dermatology Physician
  • Fort Collins, CO
National Provider Identifier
1093781007
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35113 Issued in CO
Practice address
3726 S Timberline Rd
Suite101
Fort Collins, CO 80525-3483
Phone
(970) 221-5795
Fax
(970) 221-1371
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35113 CO Primary

Addresses

Primary practice location

3726 S Timberline Rd
Suite101
Fort Collins, CO 80525-3483

Mailing address

3726 S Timberline Rd
Suite101
Fort Collins, CO 80525-3483
Phone (970) 221-5795

Other identifiers 1

IdentifierTypeStateIssuer
01279728MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060425000269 CO Practitioner - Dermatology 7214946185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Washington University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Colorado PCGroup PAC ID 8325337330, 65 clinicians

Practice addresses (Care Compare)

3726 S Timberline Rd
Suite 101
Fort Collins, CO 80525-4332
Phone (303) 744-2704

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010

Merit-based Incentive Payment System (MIPS)

Final score
82.78 of 100Reported as group
Quality
80
Promoting interoperability
84
Improvement activities
40
Cost
75.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision29
Removal of skin lesions438
Removal of nail tissue1-10
Removal or shaving of skin growth21
Skin biopsy189

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35113COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of Colorado, PC Dermatology CurrentSince Oct 14, 2016 Accepting new patients

Locations

1100 Poudre River Dr
Unit A
Fort Collins, CO 80524
Phone (970) 484-3078

3726 S Timberline Rd
Ste 101
Fort Collins, CO 80525
Phone (970) 221-2626

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

Interoperability endpoints

  • Direct secure messaging: annelise.hultsch@adcs1.emadirect.md

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 and National Provider Directory roles.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1093781007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 S TIMBERLINE RD",
            "address_2": "SUITE101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253483",
            "telephone_number": "970-221-5795",
            "fax_number": "970-221-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 S TIMBERLINE RD",
            "address_2": "SUITE101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253483",
            "telephone_number": "970-221-5795",
            "fax_number": "970-221-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULTSCH",
        "first_name": "ANNE-LISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "35113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01279728",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.