Skin PC – MOHS-Micrographic Surgery Physician

Key facts

NPI: 1710588447
Entity type: Organization (NPI type 2)
Primary specialty: MOHS-Micrographic Surgery Physician 207ND0101X
Legal business name: SKIN PC
Practice address: 78878 US Hwy 40
Winter Park, CO 80482
Phone: (706) 673-1169
Fax: (970) 669-0159
NPI assigned: Nov 9, 2020
Organization subpart: No

Authorized official

Name: Kevin John Mott, MD
Title: Owner
Phone: (303) 569-7700

Other NPIs on the same Medicare enrollment 2

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

Skin PC Dermatology Physician · Louisville, CO · NPI 1356124416

Same enrollment O20151217001504
Skin PC MOHS-Micrographic Surgery Physician · Boulder, CO · NPI 1447629886

Same enrollment O20151217001504

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Skin PC Dermatology Physician · Louisville, CO · NPI 1356124416

NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Lake Loveland Dermatology PC Dermatology Physician · Loveland, CO · NPI 1679646582

NPD member Member Of

Practitioners 2

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

Hanna K Flaten, MD Dermatology Physician · Boulder, CO · NPI 1548729791

NPD DERMATOLOGY
Kevin John Mott, MD MOHS-Micrographic Surgery Physician · Loveland, CO · NPI 1295776201

NPD DERMATOLOGY

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CO

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20151217001504	CO	Part B Supplier - Clinic/Group Practice	5395046247	Receives reassigned benefits from 7 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Boulder, CO; Louisville, CO; Winter Park, CO

National Provider Directory

Tax ID family: Skin PC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dermatology Physician Group: 193400000X SINGLE SPECIALTY GROUP	207N00000X
MOHS-Micrographic Surgery Physician Group: 193400000X SINGLE SPECIALTY GROUP	207ND0101X			Yes

Addresses

Primary practice location

78878 US Hwy 40
Winter Park, CO 80482

Mailing address

PO Box 7065
Loveland, CO 80537-0065
Phone (970) 663-2742

Other providers in Winter Park, CO

All providers in Winter Park, CO · MOHS-Micrographic Surgery Physician in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.