Boulder Valley Center for Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BOULDER VALLEY CENTER FOR DERMATOLOGY LLC

Practice address

1140 W South Boulder Rd
Ste 202
Lafayette, CO 80026-2854

Phone

(303) 604-1444

Fax

(303) 666-0911

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Tabatha Hoeben

Title

Administrator

Phone

(303) 604-1444

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Gallagher, M.D.

  • Dermatology Physician
  • Lafayette, CO
  • NPI 1922189141

  Specialist

  Medicare reassignment Care Compare group NPD
• Mary Katherine Hill, MD

  • Dermatology Physician
  • Northglenn, CO
  • NPI 1477058428
  Medicare reassignment Care Compare group NPD
• Anna Marie Zanot, MD

  • Dermatology Physician
  • Lafayette, CO
  • NPI 1336760016
  Medicare reassignment Care Compare group NPD
• Ryan Bird

  • Medical Physician Assistant
  • Lafayette, CO
  • NPI 1003220815
  Medicare reassignment Care Compare group
• Zoey Alexandra Crane, PA-C

  • Physician Assistant
  • Lafayette, CO
  • NPI 1902450034
  Medicare reassignment Care Compare group
• Madeline Jo Larson, PA-C

  • Physician Assistant
  • Lafayette, CO
  • NPI 1366247173
  Medicare reassignment Care Compare group
• Brooke Kittinger Weinberger

  • Physician Assistant
  • Lafayette, CO
  • NPI 1346820495
  Medicare reassignment Care Compare group
• Colton Wright

  • Physician Assistant
  • Lakewood, CO
  • NPI 1679335319
  Medicare reassignment Care Compare group
• Ethan Bridge

  • Physician Assistant
  • Lafayette, CO
  • NPI 1982562724
  Medicare reassignment NPD
• Trevor Fleischmann, PA-C

  • Medical Physician Assistant
  • Lafayette, CO
  • NPI 1295394641
  Medicare reassignment
• Alanna Marie Thomas, PA-C

  • Physician Assistant
  • Highlands Ranch, CO
  • NPI 1386127868
  Medicare reassignment
• Todd Charles Becker, M.D., PH.D.

  • MOHS-Micrographic Surgery Physician
  • Boulder, CO
  • NPI 1508049206
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1306927231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W SOUTH BOULDER RD",
            "address_2": "STE 202",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262854",
            "telephone_number": "303-604-1444",
            "fax_number": "303-666-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W SOUTH BOULDER RD",
            "address_2": "STE 202",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262854",
            "telephone_number": "303-604-1444",
            "fax_number": "303-666-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER VALLEY CENTER FOR DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "HOEBEN",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "303-604-1444",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boulder Emergency Physicians PC
• Boulder MRI, LLC
• Boulder Pediatric Therapy LLC
• Boulder Speech Therapy
• Boulder Valley Asthma & Allergy Clinics, PC
• Boulder Valley Gastroenterology Inc.
• Peter Boulos, M.D.
• Keith P Bowen, OD
• Rebecca Anne Bowen, AUD. M.A., CCC-A
• Barbara F Bowes

• Dermatology Physician in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.