NPIMap

Organization Active NPI

Front Range Dermatology Associates

  • Dermatopathology Physician
  • Greeley, CO
National Provider Identifier
1184973786
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
Legal business name
FRONT RANGE DERMATOLOGY ASSOCIATES
Practice address
6801 West 20TH
Suite 208
Greeley, CO 80634
Phone
(970) 673-1155
Fax
(970) 673-4747
NPI assigned
Aug 29, 2012
Last updated
Jun 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Dr. Aaron Z Hoover, MDNPI 1609883081
Title
Owner
Phone
(970) 673-1155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 49733 CO
Dermatopathology Physician 207ND0900X NU Primary

Addresses

Primary practice location

6801 West 20TH
Suite 208
Greeley, CO 80634

Mailing address

PO Box 69
Timnath, CO 80547
Phone (970) 673-1155

Other identifiers 2

IdentifierTypeStateIssuer
45021023MedicaidCO
COAAA3047OtherCOMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121015000320 CO Part B Supplier - Clinic/Group Practice 3870743578 Receives reassigned benefits from 7 practitioners
Practice locations: Fort Collins, CO; Loveland, CO; Greeley, CO; Fort Morgan, CO

National Provider Directory

National Provider Directory

Locations

4038 S Timberline Rd
Unit 100
Fort Collins, CO 80525
Phone (970) 673-1155

8223 W 20th St
Ste 100B
Greeley, CO 80634
Phone (970) 673-1155

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1184973786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "TIMNATH",
            "state": "CO",
            "postal_code": "80547",
            "telephone_number": "970-673-1155",
            "fax_number": "970-673-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 WEST 20TH",
            "address_2": "SUITE 208",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-673-1155",
            "fax_number": "970-673-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONT RANGE DERMATOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-673-1155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CO",
            "license": "49733",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45021023",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "COAAA3047",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.