Alexandra Theriault, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

38122 Issued in CO

Practice address

1420 W Canal CT
#50
Littleton, CO 80120-5655

Phone

(303) 795-2030

Fax

(303) 795-2153

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Dermatology

Education

University of Texas Medical School at Houston, 1996

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)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Center for Advanced Dermatology LLC

  • Dermatology Physician
  • Lakewood, CO
  • NPI 1497765762
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1609980713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 W CANAL CT",
            "address_2": "#50",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205655",
            "telephone_number": "303-795-2030",
            "fax_number": "303-795-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W CANAL CT",
            "address_2": "#50",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205655",
            "telephone_number": "303-795-2030",
            "fax_number": "303-795-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIAULT",
        "first_name": "ALEXANDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "38122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59251573",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Therapy Source, Inc (Little Hands Pediatric Occupational Therapy)
• The Zarlengo Foundation Learning Evaluation Center at Havern School
• Curtis Willis Theard Jr., PHARMD
• Thee Hair Counselor LLC
• Theraphysics Partners of Colorado, Inc. (Columbine Hills Physical Therapy)
• Shea Lynn Thielemann, LPC
• Florence C Thomas, NP
• Jomo Zizwe Thomas, LMFT
• Keyonna Aaliyah Thomas
• Megan Rose Ashley Thomas, MSW, ECE

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.