Organization Active NPI

Colorado Center for Dermatology, PLLC

  • Dermatology Physician
  • Centennial, CO
National Provider Identifier
1588024947
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
49752 Issued in CO
Legal business name
COLORADO CENTER FOR DERMATOLOGY, PLLC
Practice address
8008 E Arapahoe CT Ste 200
Centennial, CO 80112-6839
Phone
(303) 761-0906
Fax
(303) 761-0907
NPI assigned
Feb 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Dr. Matthew J Mahlberg, M.D.NPI 1285839928
Title
Director
Phone
(303) 761-0906

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 49752 CO Primary

Addresses

Primary practice location

8008 E Arapahoe CT Ste 200
Centennial, CO 80112-6839

Mailing address

8008 E Arapahoe CT Ste 200
Centennial, CO 80112-6839
Phone (303) 761-0906

Other practice location 1

916 S Main St Unit 201
Longmont, CO 80501-6673
Phone (303) 761-0906

Other practice location 2

6179 S Balsam Way Ste 120
Littleton, CO 80123-3092
Phone (303) 761-0906

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160406001750 CO Part B Supplier - Clinic/Group Practice 6204134372 Receives reassigned benefits from 10 practitioners
Practice locations: Longmont, CO; Centennial, 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
06D2117690Colorado Center for Dermatology, PLLC916 S Main St, Ste 201, Longmont, CO 80501ComplianceDec 21, 2026
06D2117692Colorado Center for Dermatology, PLLC8008 E Arapahoe CT, Suite 200, Centennial, CO 80112ComplianceDec 22, 2026

National Provider Directory

National Provider Directory

Locations

8008 E Arapahoe Ct
Ste 200
Centennial, CO 80112
Phone (303) 761-0906

8200 E Belleview Ave
Ste 404C
Greenwood Village, CO 80111
Phone (303) 761-0906

916 S Main St
Unit 201
Longmont, CO 80501
Phone (303) 761-0906

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1588024947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 E ARAPAHOE CT STE 200",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126839",
            "telephone_number": "303-761-0906",
            "fax_number": "303-761-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 E ARAPAHOE CT STE 200",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126839",
            "telephone_number": "303-761-0906",
            "fax_number": "303-761-0907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 S Main St Unit 201",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805016673",
            "country_code": "US",
            "telephone_number": "303-761-0906",
            "fax_number": "303-761-0907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6179 S Balsam Way Ste 120",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801233092",
            "country_code": "US",
            "telephone_number": "303-761-0906",
            "fax_number": "303-761-0907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLORADO CENTER FOR DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "MAHLBERG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-761-0906",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CO",
            "license": "49752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.

Verify at the official NPI Registry.