Active NPI
John R Steinbaugh, M.D.
- Dermatology Physician
- Boulder, CO
National Provider Identifier
1184699159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 20521
- Practice address
- 3575 Broadway St
Boulder, CO 80304-1825 - Phone
- (303) 449-0933
- Fax
- (303) 447-0794
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 20521 | CO | Primary |
| MOHS-Micrographic Surgery Physician | 207ND0101X | 20521 | CO |
Addresses
Primary practice location
3575 Broadway St
Boulder, CO 80304-1825
Mailing address
1075 Linden Ave
Boulder, CO 80304-0726
Phone (303) 449-0933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01205210 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20521 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364428800000",
"number": "1184699159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1075 LINDEN AVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803040726",
"telephone_number": "303-449-0933",
"fax_number": "303-447-0794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3575 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803041825",
"telephone_number": "303-449-0933",
"fax_number": "303-447-0794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEINBAUGH",
"first_name": "JOHN",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2013-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CO",
"license": "20521",
"primary": true
},
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "CO",
"license": "20521",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01205210",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.