NPIMap

Organization Active NPI

Monarch Dermatology & Surgery LLC

  • Dermatology Physician
  • Loveland, CO
National Provider Identifier
1629609490
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MONARCH DERMATOLOGY & SURGERY LLC
Practice address
3451 Mountain Lion Dr
Loveland, CO 80537-8817
Phone
(717) 480-2132
NPI assigned
Jan 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Ammon Larsen, MDNPI 1982044012
Title
Owner
Phone
(717) 480-2132

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0900X

Addresses

Primary practice location

3451 Mountain Lion Dr
Loveland, CO 80537-8817

Mailing address

PO Box 731
Loveland, CO 80539-0731

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hello@monarchdermco.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200318001830 CO Part B Supplier - Clinic/Group Practice 2961830369 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
Practice locations: Loveland, CO; Sterling, CO

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3451 Mountain Lion Dr
Loveland, CO 80537
Phone (970) 800-9330

Practitioners & affiliated clinicians

Practitioners 6

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": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1629609490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805390731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 MOUNTAIN LION DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805378817",
            "telephone_number": "717-480-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONARCH DERMATOLOGY & SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "AMMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-480-2132",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hello@monarchdermco.com",
            "affiliation": "N",
            "address_1": "1615 Foxtrail Dr Ste 100",
            "city": "Loveland",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805389087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.