Individual provider Active NPI

Reagan B Anderson, D.O.

  • Dermatology Physician
  • Colorado Springs, CO
National Provider Identifier
1356334965
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
48132 Issued in CO
Practice address
8580 Scarborough Dr
Suite 225
Colorado Springs, CO 80920-7586
Phone
(719) 531-5400
Fax
(719) 531-9545
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X DR.0048132 CO
Dermatology Physician 207N00000X 48132 CO Primary

Addresses

Primary practice location

8580 Scarborough Dr
Suite 225
Colorado Springs, CO 80920-7586

Mailing address

8580 Scarborough Dr
Suite 225
Colorado Springs, CO 80920-7586
Phone (719) 531-5400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100707000372 CO Practitioner - Dermatology 5294866117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rational Dermatology, PCGroup PAC ID 4385775204, 11 clinicians

Practice addresses (Care Compare)

1220 Lake Plaza Dr
Colorado Springs, CO 80906-3548
Phone (719) 531-5400

Merit-based Incentive Payment System (MIPS)

Final score
90.3 of 100Reported as individual
Quality
80.59
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision491
Removal of skin lesions719
Removal of skin cancer1387
Removal or shaving of skin growth1-10
Skin biopsy148

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48132COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rational Dermatology, PC Dermatology CurrentSince Jul 1, 2010 Accepting new patients
Rational Dermatology, PC Dermatology CurrentSince Jul 1, 2010 Accepting new patients

Locations

8580 Scarborough Dr
Ste 225
Colorado Springs, CO 80920
Phone (719) 531-5400

1220 Lake Plaza Dr
Colorado Springs, CO 80906
Phone (719) 531-5400

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1356334965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 SCARBOROUGH DR",
            "address_2": "SUITE 225",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207586",
            "telephone_number": "719-531-5400",
            "fax_number": "719-531-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8580 SCARBOROUGH DR",
            "address_2": "SUITE 225",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207586",
            "telephone_number": "719-531-5400",
            "fax_number": "719-531-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "REAGAN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CO",
            "license": "DR.0048132",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "48132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.