NPIMap

Individual provider Active NPI

Frank Mark Samarin, M.D.

  • Dermatology Physician
  • Colorado Springs, CO
National Provider Identifier
1629037395
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
49667 Issued in CO
Practice address
2465 Research Parkway
Suite 200
Colorado Springs, CO 80920
Phone
(719) 265-0100
Fax
(719) 265-0101
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 49667 CO Primary

Addresses

Primary practice location

2465 Research Parkway
Suite 200
Colorado Springs, CO 80920

Mailing address

2465 Research Parkway
Suite 200
Colorado Springs, CO 80920
Phone (719) 265-0100

Other identifiers 3

IdentifierTypeStateIssuer
COA108836OtherPTAN
1699021386MedicaidCO
73232831MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110215001046 CO Practitioner - Dermatology 0941480495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Hahneman Medical College of the Pacific, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2465 Research Pkwy
Suite 200
Colorado Springs, CO 80920-1089
Phone (719) 265-0100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision38
Removal of tissue1-10
Removal of skin lesions1044
Removal or shaving of skin growth1-10
Skin biopsy241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49667COMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Jul 1, 2021 Accepting new patients
Peak Vista Community Health Centers CurrentSince Jul 1, 2021 Accepting new patients
Mountaintop Dermatology, PLLC Dermatology CurrentSince Aug 22, 2012 Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

2465 Research Pkwy
Ste 200
Colorado Springs, CO 80920
Phone (719) 265-0100

Organizations & group practices 3

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1629037395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 RESEARCH PARKWAY",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-265-0100",
            "fax_number": "719-265-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 RESEARCH PARKWAY",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-265-0100",
            "fax_number": "719-265-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARIN",
        "first_name": "FRANK",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "49667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "COA108836",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699021386",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73232831",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.