Organization Active NPI

Dermatology Healthcare Excellence, PLLC

  • Dermatology Physician
  • Lakewood, CO
National Provider Identifier
1205519402
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY HEALTHCARE EXCELLENCE, PLLC
Practice address
9600 W Jewell Ave Ste 3
Lakewood, CO 80232-6357
Phone
(720) 778-3376
Fax
(720) 856-6117
NPI assigned
Aug 14, 2023
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Sarah Alison Basak, MDNPI 1255643813
Title
Owner/Physician
Phone
(502) 298-4664

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

9600 W Jewell Ave Ste 3
Lakewood, CO 80232-6357

Mailing address

1265 S High St
Denver, CO 80210-1808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231121001469 CO Part B Supplier - Clinic/Group Practice 4486002037 Receives reassigned benefits from 1 practitioner
Practice locations: Lakewood, CO

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2299637Dermatology Healthcare Excellence, PLLC9600 W Jewell Ave Suite 3, Lakewood, CO 80232ComplianceMay 13, 2027

National Provider Directory

National Provider Directory

Locations

9600 W Jewell Ave
Ste 3
Lakewood, CO 80232
Phone (502) 298-4664

Practitioners & affiliated clinicians

Practitioners 1

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": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1205519402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 S HIGH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802101808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 W JEWELL AVE STE 3",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802326357",
            "telephone_number": "720-778-3376",
            "fax_number": "720-856-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY HEALTHCARE EXCELLENCE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "BASAK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ALISON",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "502-298-4664",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.