Montrose Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MONTROSE DERMATOLOGY PLLC

Practice address

711 N Taylor St
Gunnison, CO 81230-2208

Phone

(970) 964-4036

Fax

(970) 964-4038

NPI assigned

Jul 16, 2021

Last updated

Jul 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelana Zimmerman

Title

Practice Manager

Phone

(970) 964-4036

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Montrose Dermatology PLLC

  dba Montrose Dermatology

  • Dermatology Physician
  • Montrose, CO
  • NPI 1154613016

  O20111212000143

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

Montrose Dermatology PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Montrose Dermatology PLLC

  • Dermatology Physician
  • Montrose, CO
  • NPI 1083532303
  NPD tax ID

Locations

Practitioners 6

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.

• Kathryn M Morlan, PA

  • Physician Assistant
  • Grand Junction, CO
  • NPI 1508006271
  NPD
• Brooke A Nosovitsky, PA-C

  • Physician Assistant
  • Montrose, CO
  • NPI 1912529462
  NPD
• Renata Raziano, MD

  • Dermatology Physician
  • Montrose, CO
  • NPI 1528105814
  NPD
• John Michael Strasswimmer, M.D.

  • Dermatology Physician
  • Salida, CO
  • NPI 1871577700
  NPD
• Bridget Walker, M.D.

  • MOHS-Micrographic Surgery Physician
  • Montrose, CO
  • NPI 1811484843

  Dermatology

  NPD
• Marla D Beavers, PA-C

  • Physician Assistant
  • Weatherford, TX
  • NPI 1902876246
  NPD (past)

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1497328538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 COMMERCIAL WAY",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015693",
            "telephone_number": "970-964-4036",
            "fax_number": "970-964-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N TAYLOR ST",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812302208",
            "telephone_number": "970-964-4036",
            "fax_number": "970-964-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTROSE DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "MICHELANA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "970-964-4036"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Muzzarelli Mochulsky, P.A.
• Michele Mogel
• Brian Kent Moloney, M.D.
• Amy Renee Monitello, CRNA
• Emily Montesinos, CD
• Montrose Memorial Hospital, Inc (Montrose Cardiology at Gunnison)
• Montrose Memorial Hospital, Inc (Montrose Regional Health Pulmonology Clinic Gunnison)
• Montrose Regional Health Pso, LLC
• Moore Speech Therapy
• Jennifer M Moore, SLP

• Dermatology Physician in Gunnison, CO
• Providers in Gunnison, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.