Kevin John Mott, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

53082 Issued in CO

Practice address

1708 Boise Ave
Loveland, CO 80538-4204

Phone

(970) 667-3116

Fax

(970) 669-0159

NPI assigned

Jun 9, 2006

Last updated

Nov 5, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Iowa, RJ & L Carver College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Loveland Dermatology PCGroup PAC ID 1456329655, 5 clinicians

Skin PCGroup PAC ID 5395046247, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Loveland, CO
  • NPI 1679646582
  Medicare reassignment Care Compare group NPD Authorized official
• Skin PC

  • MOHS-Micrographic Surgery Physician
  • Boulder, CO
  • NPI 1447629886

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1700487675
  NPD Authorized official
• Skin PC

  • MOHS-Micrographic Surgery Physician
  • Winter Park, CO
  • NPI 1710588447

  Dermatology

  NPD Authorized official
• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Windsor, CO
  • NPI 1073114948
  Authorized official Same address or phone
• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Estes Park, CO
  • NPI 1265033138
  NPD (past) Authorized official
• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Sterling, CO
  • NPI 1437750304
  NPD (past) Authorized official
• Skin PC

  dba Ideal Dermatology

  • Dermatology Physician
  • Louisville, CO
  • NPI 1356124416
  Authorized official Same address or phone
• Hawaii Skin Cancer and Photodamage Center, Inc

  • Specialist
  • Honolulu, HI
  • NPI 1417133802
  NPD (past) Authorized official
• Ingerlisa Mattoch MD Inc

  dba Tiaga Pathology

  • Dermatopathology (Pathology) Physician
  • Loveland, CO
  • NPI 1467190736
  NPD

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1295776201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7643",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370643",
            "telephone_number": "970-663-2742",
            "fax_number": "970-342-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 BOISE AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805384204",
            "telephone_number": "970-667-3116",
            "fax_number": "970-669-0159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "776 W Eisenhower Blvd",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805373157",
            "country_code": "US",
            "telephone_number": "970-667-3116",
            "fax_number": "970-669-0159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 Alpine Ave",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043305",
            "country_code": "US",
            "telephone_number": "303-569-7700",
            "fax_number": "303-353-0415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTT",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "53082",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "HI",
            "license": "6814",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CO",
            "license": "53082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Mortellite, D.P.T.
• Sunny Rae Mosal, RN
• Christina Moselle, LPC
• Michelle Lois Moses, DO
• Deborah Jean Motl
• Princess Paige Mott, D.C
• Mountainside Therapy, LLC
• Mandy Mouton
• Movement Mechanics
• Sarah Mowder, MSW

• MOHS-Micrographic Surgery Physician in Loveland, CO
• Providers in Loveland, CO by specialty
• MOHS-Micrographic Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.