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Individual provider Active NPI

Kevin L Whaley, MD

  • Dermatology Physician
  • Colorado Springs, CO
National Provider Identifier
1336186246
Registry record updated Jul 21, 2022
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Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
33020 Issued in CO
Practice address
8890 N Union Blvd
Suite 207
Colorado Springs, CO 80920
Phone
(719) 667-0888
Fax
(719) 667-0808
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 33020 CO
Procedural Dermatology Physician 207NS0135X 33020 CO
Dermatology Physician 207N00000X 33020 CO Primary

Addresses

Primary practice location

8890 N Union Blvd
Suite 207
Colorado Springs, CO 80920

Mailing address

8890 N Union Blvd
Suite 207
Colorado Springs, CO 80920
Phone (719) 667-0888

Other practice location 1

17230 Jackson Creek Pkwy Ste 200
Monument, CO 80132-7304
Phone (719) 667-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427000657 CO Practitioner - Dermatology 4688661200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Colorado School of Medicine, Denver, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Dermatology, P.C.Group PAC ID 2860582798, 2 clinicians

Practice addresses (Care Compare)

8890 N Union Blvd
Suite 207
Colorado Springs, CO 80920-2701
Phone (719) 667-0888

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1126
Removal of skin cancer97
Removal or shaving of skin growth24
Skin biopsy223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33020COMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Dermatology, P.C. CurrentSince Mar 31, 2000 Accepting new patients

Locations

8890 N Union Blvd
Ste 207
Colorado Springs, CO 80920
Phone (709) 337-0888

Organizations & group practices 1

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336186246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8890 N UNION BLVD",
            "address_2": "SUITE 207",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-667-0888",
            "fax_number": "719-667-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8890 N UNION BLVD",
            "address_2": "SUITE 207",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-667-0888",
            "fax_number": "719-667-0808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17230 Jackson Creek Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Monument",
            "state": "CO",
            "postal_code": "801327304",
            "country_code": "US",
            "telephone_number": "719-667-0888",
            "fax_number": "719-667-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CO",
            "license": "33020",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CO",
            "license": "33020",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "33020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.