NPIMap

Organization Active NPI

Colorado Springs Dermatology Clinic, P.C.

  • MOHS-Micrographic Surgery Physician
  • Colorado Springs, CO
National Provider Identifier
1891392973
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
COLORADO SPRINGS DERMATOLOGY CLINIC, P.C.
Practice address
2060 Briargate Pkwy Ste 150
Colorado Springs, CO 80920-7660
Phone
(719) 471-1763
Fax
(719) 471-2498
NPI assigned
Oct 2, 2020
Last updated
Sep 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Authorized official

Name
Heather Milenski
Title
Billing Department Manager
Phone
(719) 471-1763

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
MOHS-Micrographic Surgery Physician 207ND0101X NU Primary

Addresses

Primary practice location

2060 Briargate Pkwy Ste 150
Colorado Springs, CO 80920-7660

Mailing address

170 S Parkside Dr
Colorado Springs, CO 80910-3129
Phone (719) 471-1763

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2187741Colorado Springs Dermatology Clinic, PC2060 Briargate Parkway, Suite 150, Colorado Springs, CO 80920ComplianceJun 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Colorado Springs Dermatology Clinic PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

170 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 471-1763

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1891392973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 S PARKSIDE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103129",
            "telephone_number": "719-471-1763",
            "fax_number": "719-471-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 BRIARGATE PKWY STE 150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207660",
            "telephone_number": "719-471-1763",
            "fax_number": "719-471-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPRINGS DERMATOLOGY CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "MILENSKI",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "BILLING DEPARTMENT MANAGER",
        "authorized_official_telephone_number": "719-471-1763"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.