Jason Ryan Mammino

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0066760 Issued in CO

Practice address

4344 Woodlands Blvd Ste 160
Castle Rock, CO 80104-2801

Phone

(303) 350-4500

NPI assigned

Apr 19, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

DermatologyAlso: Osteopathic Manipulative Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Colorado PCGroup PAC ID 8325337330, 65 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.78 of 100Reported as group

Quality

80

Promoting interoperability

84

Improvement activities

40

Cost

75.92

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Advanced Dermatology of Colorado, PC

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1710370648
  Medicare reassignment Care Compare group NPD
• Leslie R Capin MD PC

  dba Dermatology Associates of Colorado PC

  • Dermatology Physician
  • Aurora, CO
  • NPI 1619916079
  NPD (past)

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1548757073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4344 WOODLANDS BLVD STE 160",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042801",
            "telephone_number": "303-350-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 WOODLANDS BLVD STE 160",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042801",
            "telephone_number": "303-350-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMINO",
        "first_name": "JASON",
        "middle_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "0066760",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maher Counseling, LLC
• Velami Kaye Maher, MA, LMFT, LPC
• Nancy Ann Maier, RN, PMHCNS-BC
• Ciara Malave
• Zena Maldonado, PA-C
• Anne C Manchester, MD
• Sabrina Mancini
• Madelyn Rose Mandese, M.S. CCC-SLP
• Taliah R Mapes, L.AC.
• Craig Maples, DO

• Dermatology Physician in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.