Active NPI
Skinwise Dermatology Clinic, P.C.
- Dermatology Physician
- Louisville, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- 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, 2024
- Organization subpart
- No
NPPES NPI Registry
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.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59953241 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D1094064 | Skinwise Dermatology Clinic, PC | Certificate of waiver | Jan 9, 2028 |
National Provider Directory
National Provider DirectoryLocations
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
- 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.
-
- Dermatology Physician
- Louisville, CO
- NPI 1528033834
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.