Ingerlisa Wenche Mattoch, M.D.

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

49136 Issued in CO

Practice address

1708 N. Boise
Loveland, CO 80538-4204

Phone

(970) 818-6788

Fax

(970) 669-0159

NPI assigned

Oct 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, AZ2 enrollments

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 2

Specialty

Pathology

Education

Boston University School of Medicine, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Regency Skin Institute PLLCGroup PAC ID 5193097665, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

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 and National Provider Directory roles.

• Ingerlisa Mattoch MD Inc

  • Dermatopathology (Pathology) Physician
  • Loveland, CO
  • NPI 1467190736
  Medicare reassignment NPD Authorized official
• Regency Skin Institute PLLC

  • MOHS-Micrographic Surgery Physician
  • Surprise, AZ
  • NPI 1932630563
  Medicare reassignment Care Compare group NPD
• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Loveland, CO
  • NPI 1679646582
  Medicare reassignment NPD
• Mpath, LLC

  • Anatomic Pathology Physician
  • Loveland, CO
  • NPI 1689274318
  NPD Authorized official
• Lake Loveland Dermatology PC

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1700487675
  NPD
• Lake Loveland Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Loveland, CO
  • NPI 1578604120
  NPD (past)
• Cta Oral Pathology Consultants of Michigan, PLLC

  • Oral and Maxillofacial Pathology Dentistry
  • Ann Arbor, MI
  • NPI 1366244550
  NPD (past)

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1306034582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7268",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370268",
            "telephone_number": "970-818-6788",
            "fax_number": "970-669-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 N. BOISE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805384204",
            "telephone_number": "970-818-6788",
            "fax_number": "970-669-0159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 Boise Ave",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805384204",
            "country_code": "US",
            "telephone_number": "970-818-6788",
            "fax_number": "970-669-0159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTOCH",
        "first_name": "INGERLISA",
        "middle_name": "WENCHE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CO",
            "license": "DR.0049136",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CO",
            "license": "49136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dave Matheson, PHD
• Marta Matloch
• Samantha Mattei, OTR/L
• Nicole M Matthews, M.D.
• Rebekah Matthews
• Jayme Anne Maurer
• Pamela Mausner, M.D.
• Peter Maxwell, MD
• Thomas Lee Maybee
• MBBK Consulting Inc.

• Dermatopathology (Pathology) Physician in Loveland, CO
• Providers in Loveland, CO by specialty
• Dermatopathology (Pathology) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.