Individual provider Active NPI

Joseph Simodynes, MD

  • Dermatology Physician
  • Thornton, CO
National Provider Identifier
1770620031
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
45748 Issued in CO
Practice address
1551 Milky Way
Thornton, CO 80260-4713
Phone
(303) 426-4525
NPI assigned
Jan 30, 2007
Last updated
Feb 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 45748 CO Primary
Procedural Dermatology Physician 207NS0135X 45748 CO

Addresses

Primary practice location

1551 Milky Way
Thornton, CO 80260-4713

Mailing address

1551 Milky Way
Thornton, CO 80260-4713
Phone (303) 426-4525

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070810000595 CO Practitioner - Dermatology 3779674353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Nebraska College of Medicine, 2003
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)

10359 Federal Blvd
Westminster, CO 80260-7453
Phone (303) 426-4525

1100 Poudre River Dr
Unit a
Fort Collins, CO 80524-3557
Phone (970) 484-3050

3455 Lutheran Pkwy
Suite 110
Wheat Ridge, CO 80033-6041
Phone (303) 426-4525

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
Melanoma (skin cancer) excision84
Removal of skin lesions1411
Removal or shaving of skin growth1-10
Skin biopsy603

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45748COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of Colorado, PC Dermatology CurrentSince Oct 14, 2016 Accepting new patients
Major Hospital Past Accepting new patients

Locations

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

1551 Milky Way
Thornton, CO 80260
Phone (303) 340-3405

10359 Federal Blvd
Ste 210
Westminster, CO 80260
Phone (303) 404-0200

3455 Lutheran Pkwy
Ste 110
Wheat Ridge, CO 80033
Phone (303) 318-2900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1770620031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 MILKY WAY",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802604713",
            "telephone_number": "303-426-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 MILKY WAY",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802604713",
            "telephone_number": "303-426-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMODYNES",
        "first_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "45748",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CO",
            "license": "45748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.