Active NPI
Roya Brooke Mirhossaini
- Dermatology Physician
- Colorado Springs, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- DR.0073701
- Practice address
- 2060 Briargate Pkwy Ste 150
Colorado Springs, CO 80920-7660 - Phone
- (719) 471-1763
- Fax
- (719) 471-2498
- NPI assigned
- Mar 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dermatology Physician | 207N00000X | DR.0073701 | CO | Primary |
Addresses
Primary practice location
2060 Briargate Pkwy Ste 150
Colorado Springs, CO 80920-7660
Mailing address
2060 Briargate Pkwy Ste 150
Colorado Springs, CO 80920-7660
Phone (719) 471-1763
Other practice location 1
4445 Magnolia Ave
Riverside, CA 92501-4199
Phone (951) 788-3536
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of Colorado School of Medicine, Aurora, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2060 Briargate Pkwy
Suite 150
Colorado Springs, CO 80920-7660
Phone 7194711763204
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 27 |
| Removal of skin lesions | 676 |
| Removal or shaving of skin growth | 53 |
| Skin biopsy | 357 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Springs Dermatology Clinic, P.C. | Dermatology | Current | Accepting new patients |
| Colorado Springs Dermatology Clinic, P.C. | Dermatology | Current | Accepting new patients |
| Colorado Springs Dermatology Clinic, P.C. | Dermatology | Current | Accepting new patients |
Locations
1332 Bauer Ln
Canon City, CO 81212
Phone (719) 275-7485
2060 Briargate Pkwy
Ste 150
Colorado Springs, CO 80920
Phone (719) 471-1763
170 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 471-1763
406 N Main St
Pueblo, CO 81003
Phone (719) 566-0176
Interoperability endpoints
- rmirhossaini@csderm.emadirect.md
Organizations & group practices 3
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.
-
- MOHS-Micrographic Surgery Physician
- Colorado Springs, CO
- NPI 1801901517
Dermatology
-
- MOHS-Micrographic Surgery Physician
- Pueblo, CO
- NPI 1386241453
Dermatology
-
- MOHS-Micrographic Surgery Physician
- Colorado Springs, CO
- NPI 1891392973
Dermatology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1356979181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2060 BRIARGATE PKWY STE 150",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809207660",
"telephone_number": "719-471-1763",
"fax_number": "719-471-2498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2060 BRIARGATE PKWY STE 150",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809207660",
"telephone_number": "719-471-1763",
"fax_number": "719-471-2498"
}
],
"practiceLocations": [
{
"address_1": "4445 Magnolia Ave",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "CA",
"postal_code": "925014199",
"country_code": "US",
"telephone_number": "951-788-3536",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRHOSSAINI",
"first_name": "ROYA",
"middle_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-28",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CO",
"license": "DR.0073701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.