NPIMap

Individual provider Active NPI

Nicole S Stefanko, MD

  • Dermatology Physician
  • Fort Collins, CO
National Provider Identifier
1740743715
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
DR.0070457 Issued in CO
Practice address
3726 S Timberline Rd Ste 101
Fort Collins, CO 80525-4332
Phone
(970) 221-5795
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 DR.0070457 CO Primary

Addresses

Primary practice location

3726 S Timberline Rd Ste 101
Fort Collins, CO 80525-4332

Mailing address

3726 S Timberline Rd Ste 101
Fort Collins, CO 80525-4332
Phone (970) 221-5795

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
I20230811003189 CO Practitioner - Dermatology 7012347503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Cincinnati College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Colorado PCGroup PAC ID 8325337330, 65 clinicians

Practice addresses (Care Compare)

3726 S Timberline Rd
Suite 101
Fort Collins, CO 80525-4332
Phone (303) 744-2704

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.78 of 100Reported as group
Quality
80
Promoting interoperability
84
Improvement activities
40
Cost
75.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions739
Skin biopsy152

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0070457COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of Colorado, PC Dermatology CurrentSince Jul 1, 2023 Accepting new patients
Dermatology of Northern Colorado P.C. Dermatology PastSince Jul 1, 2023 Accepting new patients

Locations

1100 Poudre River Dr
Unit A
Fort Collins, CO 80524
Phone (970) 484-3078

3726 S Timberline Rd
Ste 101
Fort Collins, CO 80525
Phone (970) 221-2626

1006 Centre Ave
Fort Collins, CO 80526
Phone (970) 482-9001

1880 Fall River Dr
Ste 210
Loveland, CO 80538
Phone (970) 484-6303

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

Organizations & group practices 2

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1740743715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 S TIMBERLINE RD STE 101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254332",
            "telephone_number": "970-221-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 S TIMBERLINE RD STE 101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254332",
            "telephone_number": "970-221-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANKO",
        "first_name": "NICOLE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0070457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.