Individual provider Active NPI

Tiffany Lee Tello, M.D.

  • Dermatology Physician
  • Littleton, CO
National Provider Identifier
1457793283
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0060196 Issued in CO
Practice address
1420 W Canal CT Ste 50
Littleton, CO 80120
Phone
(303) 795-2030
NPI assigned
Jul 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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 0060196 CO
Dermatology Physician 207N00000X 0060196 CO Primary

Addresses

Primary practice location

1420 W Canal CT Ste 50
Littleton, CO 80120

Mailing address

5310 Harvest Hill Rd Ste 290
Dallas, TX 75230-5826
Phone (214) 420-0650

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
I20180709000088 CO Practitioner - DermatologyPractitioner - Pathology 3173818697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
University of Colorado School of Medicine, Denver, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Advanced Dermatology LLCGroup PAC ID 0143208827, 21 clinicians

Practice addresses (Care Compare)

3455 S Yarrow St
Lakewood, CO 80227-5031
Phone (303) 989-5231

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision77
Removal of tissue1-10
Removal of skin lesions28
Removal of skin cancer426
Skin biopsy22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0060196COMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Advanced Dermatology LLC Dermatology CurrentSince Feb 27, 2019 Accepting new patients

Locations

125 Rampart Way
Ste 220
Denver, CO 80230
Phone (303) 261-1525

3455 S Yarrow St
Lakewood, CO 80227
Phone (303) 848-3047

1420 W Canal Ct
Ste 50
Littleton, CO 80120
Phone (303) 795-2030

Organizations & group practices 1

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": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1457793283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 HARVEST HILL RD STE 290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752305826",
            "telephone_number": "214-420-0650",
            "fax_number": "214-736-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W CANAL CT STE 50",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "80120",
            "telephone_number": "303-795-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLO",
        "first_name": "TIFFANY",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CO",
            "license": "0060196",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "0060196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.