Colorado Dermatology Group, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

DR.0047867 Issued in CO

Legal business name

COLORADO DERMATOLOGY GROUP, PLLC

Practice address

3609 S Timberline Rd Unit a
Fort Collins, CO 80525-3430

Phone

(888) 884-6776

Fax

(970) 482-9948

NPI assigned

Aug 29, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Joseph V Lillis, M.D.NPI 1225213432

Title

Owner

Phone

(888) 884-6776

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Vincent Lillis, M.D.

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1225213432
  Medicare reassignment Care Compare group Authorized official
• Brooke Ann Caufield, MD

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1063593184
  Medicare reassignment Care Compare group NPD
• Jennifer Anne Sbicca, M.D.

  • Dermatology Physician
  • Denver, CO
  • NPI 1396003935
  Medicare reassignment Care Compare group NPD
• Elise Van Leuven

  • Physician Assistant
  • Colorado Springs, CO
  • NPI 1619612009
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1144776238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 S TIMBERLINE RD UNIT A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253430",
            "telephone_number": "888-884-6776",
            "fax_number": "970-482-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 S TIMBERLINE RD UNIT A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253430",
            "telephone_number": "888-884-6776",
            "fax_number": "970-482-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DERMATOLOGY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "LILLIS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-884-6776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0047867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colorado Allergy and Asthma Centers, PC
• Colorado Assessment and Treatment Center Inc
• Colorado Assessment and Treatment Center Inc
• Colorado Brian Training, Inc
• Colorado Dental Specialist Practice, LLC
• Colorado Divorce Options, Inc
• Colorado Divorce Options, PC
• Colorado in Motion LLC
• Colorado in Motion LLC
• Colorado in Motion LLC

• Dermatology Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.