Individual provider Active NPI

Jessica Mounessa Farahi, M.D.

  • Dermatology Physician
  • Denver, CO
National Provider Identifier
1376075812
Registry record updated Aug 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
DR.0066767 Issued in CO
Practice address
2045 N Franklin St
Denver, CO 80205-5437
Phone
(303) 338-4545
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X DR.0066767 CO Primary

Addresses

Primary practice location

2045 N Franklin St
Denver, CO 80205-5437

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other identifiers 1

IdentifierTypeStateIssuer
029196OtherCOKAISER COMMERCIAL NUMBER

Other names 1

  • Jessica Sharon Mounessa Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20210826001354 CO Practitioner - Dermatology 7214201128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
State University of New York at Stony Brook, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samantha Ghiselli MD PLLCGroup PAC ID 8820485261, 4 clinicians

Practice addresses (Care Compare)

501 S Cherry St
Suite 310
Glendale, CO 80246-1322
Phone (303) 333-7873

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions459
Skin biopsy73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samantha Ghiselli MD PLLC Dermatology CurrentSince Nov 1, 2022 Accepting new patients
Pure Dermatology PLLC Dermatology Current Accepting new patients

Locations

501 S Cherry St
Ste 310
Glendale, CO 80246
Phone (303) 333-7873

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629504000000",
    "number": "1376075812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 N FRANKLIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055437",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAHI",
        "first_name": "JESSICA",
        "middle_name": "MOUNESSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2021-08-21",
        "certification_date": "2021-08-21",
        "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.0066767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029196",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2045 N Franklin St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802055437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MOUNESSA",
            "middle_name": "SHARON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.