Organization Active NPI

Mountain West Dermatology, PC

  • Dermatology Physician
  • Grand Junction, CO
National Provider Identifier
1497871073
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MOUNTAIN WEST DERMATOLOGY, PC
Practice address
2655 Little Bookcliff Dr
Grand Junction, CO 81501-8801
Phone
(970) 242-7273
Fax
(970) 241-2878
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Authorized official

Name
Dr. Leroy Arthur Weber, MDNPI 1023076122
Title
President
Phone
(970) 242-7273

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

2655 Little Bookcliff Dr
Grand Junction, CO 81501-8801

Mailing address

2655 Little Bookcliff Dr
Grand Junction, CO 81501-8801
Phone (970) 242-7273

Other identifiers 1

IdentifierTypeStateIssuer
0425037MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329001153 CO Part B Supplier - Clinic/Group Practice 5496647828 Receives reassigned benefits from 9 practitioners
Practice locations: Grand Junction, 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
06D0690312Mountain West Dermatology PC2655 Little Bookcliff Dr, Grand Junction, CO 81501ComplianceSep 27, 2026

National Provider Directory

National Provider Directory

Locations

2655 Little Bookcliff Dr
Grand Junction, CO 81501
Phone (970) 242-7273

790 Wellington Ave
Ste 104
Grand Junction, CO 81501
Phone (970) 242-7273

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1497871073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 LITTLE BOOKCLIFF DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018801",
            "telephone_number": "970-242-7273",
            "fax_number": "970-241-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 LITTLE BOOKCLIFF DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018801",
            "telephone_number": "970-242-7273",
            "fax_number": "970-241-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN WEST DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-242-7273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "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": "0425037",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.