NPIMap

Individual provider Active NPI

Cathy Lynn Koger, D.O.

  • Dermatology Physician
  • Boulder, CO
National Provider Identifier
1902194871
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
53663 Issued in CO
Practice address
3434 47TH St Ste 200
Boulder, CO 80301-1817
Phone
(303) 444-8100
Fax
(303) 444-8113
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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 53663 CO Primary

Addresses

Primary practice location

3434 47TH St Ste 200
Boulder, CO 80301-1817

Mailing address

3434 47TH St Ste 200
Boulder, CO 80301-1817
Phone (303) 444-8100

Other identifiers 1

IdentifierTypeStateIssuer
53663OtherCOMEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crkoger@kallgrenderm.emadirect.md Direct

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
I20141009001987 CO Practitioner - Dermatology 0345460572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K2 Dermatology LLCGroup PAC ID 9638547474, 6 clinicians

Practice addresses (Care Compare)

3434 47TH St
Suite 200
Boulder, CO 80301-1817
Phone (303) 444-8100

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision65
Removal of skin lesions1473
Removal or shaving of skin growth1-10
Skin biopsy325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53663COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
K2 Dermatology, LLC Dermatology CurrentSince Jan 1, 2023 Accepting new patients

Locations

3434 47th St
Ste 200
Boulder, CO 80301
Phone (303) 444-8100

Interoperability endpoints

  • Direct secure messaging: crkoger@kallgrenderm.emadirect.md

Organizations & group practices 1

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1902194871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 47TH ST STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011817",
            "telephone_number": "303-444-8100",
            "fax_number": "303-444-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 47TH ST STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011817",
            "telephone_number": "303-444-8100",
            "fax_number": "303-444-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGER",
        "first_name": "CATHY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "53663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "53663",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crkoger@kallgrenderm.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "EMR Direct Mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3434 47th St Ste 200",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803011817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.