Individual provider Active NPI

Ryan Gamble, MD

  • Dermatology Physician
  • Aurora, CO
National Provider Identifier
1881988913
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
DR.0054904 Issued in CO
Practice address
1390 S Potomac St
Suite 124
Aurora, CO 80012-6165
Phone
(303) 368-9791
NPI assigned
Jun 6, 2011
Last updated
Aug 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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.0054904 CO Primary

Addresses

Primary practice location

1390 S Potomac St
Suite 124
Aurora, CO 80012-6165

Mailing address

1390 S Potomac St
Suite 124
Aurora, CO 80012-6165
Phone (303) 368-9791

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
I20151105000836 CO Practitioner - Dermatology 7810139698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Colorado School of Medicine, Denver, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1390 S Potomac St
Suite 124
Aurora, CO 80012-4529
Phone (303) 368-8611

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as group
Quality
100
Promoting interoperability
96
Improvement activities
40
Cost
73.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1021
Removal or shaving of skin growth107
Skin biopsy425

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0054904COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology Skin Cancer & Laser Surgery Center P.C. Dermatology CurrentSince Aug 15, 2015 Accepting new patients
Advanced Dermatology Skin Cancer & Laser Surgery Center P.C. Dermatology CurrentSince Aug 15, 2015 Accepting new patients

Locations

1390 S Potomac St
Ste 124
Denver, CO 80012
Phone (303) 368-8611

3464 S Willow St
Ste 194
Denver, CO 80231

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": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1881988913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 S POTOMAC ST",
            "address_2": "SUITE 124",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800126165",
            "telephone_number": "303-368-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 S POTOMAC ST",
            "address_2": "SUITE 124",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800126165",
            "telephone_number": "303-368-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0054904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.