Organization Active NPI

Skinwise Dermatology Clinic, P.C.

  • Dermatology Physician
  • Louisville, CO
National Provider Identifier
1447496526
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SKINWISE DERMATOLOGY CLINIC, P.C.
Practice address
1371 Hecla Dr Ste C2
Louisville, CO 80027-2318
Phone
(303) 427-0432
Fax
(855) 504-1008
NPI assigned
Dec 19, 2008
Last updated
Apr 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Dr. Yan Isabel Zhu, M.D.NPI 1528033834
Title
Physician/Owner
Phone
(303) 521-2645

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1371 Hecla Dr Ste C2
Louisville, CO 80027-2318

Mailing address

1371 Hecla Dr Ste C2
Louisville, CO 80027-2318
Phone (303) 427-0432

Other identifiers 1

IdentifierTypeStateIssuer
59953241MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090313000053 CO Part B Supplier - Clinic/Group Practice 2062578214 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D1094064Skinwise Dermatology Clinic, PC1371 Hecla Dr, Suite C2, Louisville, CO 80027Certificate of waiverJan 9, 2028

National Provider Directory

National Provider Directory

Locations

4810 Riverbend Rd
Ste C2
Boulder, CO 80301
Phone (303) 427-0432

1371 Hecla Dr
Louisville, CO 80027

1371 Hecla Dr
Ste C2
Louisville, CO 80027
Phone (303) 427-0432

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDEGAA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1447496526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 HECLA DR STE C2",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800272318",
            "telephone_number": "303-427-0432",
            "fax_number": "855-504-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 HECLA DR STE C2",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800272318",
            "telephone_number": "303-427-0432",
            "fax_number": "855-504-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKINWISE DERMATOLOGY CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-19",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "ZHU",
        "authorized_official_first_name": "YAN",
        "authorized_official_middle_name": "ISABEL",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "303-521-2645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59953241",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
  • 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.

Verify at the official NPI Registry.