Krystal J Holderness Nakamura, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

44146 Issued in CO

Practice address

2001 Lake Ave
Pueblo, CO 81004-3538

Phone

(719) 564-5544

NPI assigned

Jan 25, 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

Tulane University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin Cancer and Dermatology Center of Colorado Springs, P.C.Group PAC ID 2769474840, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.28 of 100Reported as group

Quality

97.05

Promoting interoperability

100

Improvement activities

40

Cost

63.87

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: knakamura@skincancerandderm.emadirect.md

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.

• Skin Cancer and Dermatology Center of Colorado Springs, P.C.

  • Dermatology Physician
  • Colorado SPGS, CO
  • NPI 1588631055
  Medicare reassignment Care Compare group NPD
• Skin Cancer and Dermatology Center of Colorado Springs, P.C.

  • Dermatology Physician
  • Trinidad, CO
  • NPI 1275120347
  NPD
• Skin Cancer and Dermatology Center of Colorado Springs, P.C.

  • Dermatology Physician
  • Pueblo, CO
  • NPI 1770275323
  NPD

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1669442422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LAKE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043538",
            "telephone_number": "719-564-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAKE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043538",
            "telephone_number": "719-564-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDERNESS NAKAMURA",
        "first_name": "KRYSTAL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "44146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26722054",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald L. D. Hoffmann, R.PH.
• Joshua Wade Hogins, D.O.
• Mackenzie Jill Holcomb, OTD
• Koryn Holden
• Philip Breedee Holden, DDS
• Holistic Wellness LLC
• Ursula Lynette Hollins, MSW, LPN, LAC
• Shane Hollis
• Angelica Holloway
• Jenna Holloway

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.