Accent Dermatology and Laser Institute, PLLC
Organization Active NPI Dermatology Physician · Golden, CO
NPI 1336409705 · NPPES record last updated May 20, 2012
Key facts
- NPI
- 1336409705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 25124 (CO)
- Legal business name
- ACCENT DERMATOLOGY AND LASER INSTITUTE, PLLC
- Practice address
- 400 Indiana St
Suite #390
Golden, CO 80401-5027 - Phone
- (303) 463-9600
- Fax
- (303) 403-9919
- NPI assigned
- May 20, 2012
- Organization subpart
- No
Authorized official
- Name
- Kathleen Yumi Sawada, M.D.
- Title
- MD
- Phone
- (303) 463-9600
Practitioners 7
-
Tracy A. Haines, M.D.
-
Tyler Owen Vukmer, D.O.
-
Ashley Martin, PA-C
-
Kerri L Zukosky, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D1006968 | Accent Dermatology and Laser Institute | Provider-performed microscopy | Aug 14, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120906000310 | CO | Part B Supplier - Clinic/Group Practice | 1355598822 |
Receives reassigned benefits from 7 practitioners Practice locations: Golden, CO |
National Provider Directory
Locations
350 Indiana St
Ste 500
Golden, CO 80401
Phone (303) 463-9600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | 25124 | CO | Yes |
Addresses
Primary practice location
400 Indiana St
Suite #390
Golden, CO 80401-5027
Mailing address
400 Indiana St
Suite #390
Golden, CO 80401-5027
Phone (303) 463-9600
Other providers in Golden, CO
- Taylor L Abner
- Accelerated Home Healthcare Inc
- Accelerated Medical Services
- Accelerated Medical Services
- Accelerated Medical Services Inc
- Accessible-Tech LLC
- Active Belief
- Cayle Adams
- Clarence Edward Adams Jr.
- Lindsey Adams
All providers in Golden, CO · Dermatology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.