NPIMap

Individual provider Active NPI

Adam Vaudreuil, MD

  • Dermatology Physician
  • Castle Rock, CO
National Provider Identifier
1922529965
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
DR.0066127 Issued in CO
Practice address
1175 S Perry St Ste 220
Castle Rock, CO 80104-0017
Phone
(720) 615-6400
NPI assigned
Jun 29, 2017
Reactivated
Jul 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 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 DR.0066127 CO Primary

Addresses

Primary practice location

1175 S Perry St Ste 220
Castle Rock, CO 80104-0017

Mailing address

9348 Grand Cordera Pkwy Ste 160
Colorado Springs, CO 80924-7023
Phone (719) 355-1585

Other practice location 1

9397 Crown Crest Blvd Ste 230
Parker, CO 80138-8576
Phone (720) 615-6400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vanguardmedicalspecialists@direct.vanguardmed.nextgenshare.com

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
I20210526001933 CO Practitioner - Dermatology 9638443815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Creighton University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanguard Medical Specialists, LLCGroup PAC ID 9436209285, 23 clinicians

Practice addresses (Care Compare)

9348 Grand Cordera Pkwy
Suite 160
Colorado Springs, CO 80924-7023
Phone (719) 355-1585

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

Merit-based Incentive Payment System (MIPS)

Final score
87.69 of 100Reported as group
Quality
86.72
Promoting interoperability
100
Improvement activities
40
Cost
72.25

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision76
Removal of skin lesions857
Skin biopsy203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8087NEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanguard Medical Specialists LLC Dermatology Current Accepting new patients
Vanguard Medical Specialists, LLC Dermatology CurrentSince Jul 1, 2021 Accepting new patients
Vanguard Medical Specialists LLC Dermatology CurrentSince Jul 1, 2021 Accepting new patients
Vanguard Medical Specialists, LLC Dermatology Past Accepting new patients
Vanguard Medical Specialists LLC Dermatology Past Accepting new patients

Locations

109 Latigo Ln
Ste F
Canon City, CO 81212

1175 S Perry St
Ste 220
Castle Rock, CO 80104
Phone (303) 688-5025

9348 Grand Cordera Pkwy
Ste 160
Colorado Springs, CO 80924

2620 Tenderfoot Hill St
Ste 110
Colorado Springs, CO 80906

6215 Corporate Dr
Ste 101
Colorado Springs, CO 80919

13492 Bass Pro Dr
Ste 100
Colorado Springs, CO 80921

9397 Crown Crest Blvd
Ste 230
Parker, CO 80138
Phone (303) 805-1800

5700 N Elizabeth St
Ste 160
Pueblo, CO 81008

41 State Highway 67
Unit B
Woodland Park, CO 80863

Interoperability endpoints

  • Direct secure messaging: adam.vaudreuil.p1@direct.vanguardmed.nextgenshare.com

Organizations & group practices 5

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1922529965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9348 GRAND CORDERA PKWY STE 160",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247023",
            "telephone_number": "719-355-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 S PERRY ST STE 220",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801040017",
            "telephone_number": "720-615-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9397 Crown Crest Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801388576",
            "country_code": "US",
            "telephone_number": "720-615-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUDREUIL",
        "first_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "deactivation_date": "2018-07-11",
        "reactivation_date": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0066127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vanguardmedicalspecialists@direct.vanguardmed.nextgenshare.com",
            "affiliation": "N",
            "address_1": "9348 Grand Cordera Pkwy Ste 160",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809247023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.