Samantha Fay Ghiselli, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

51663 Issued in CO

Practice address

501 S Cherry St Ste 310
Glendale, CO 80246-1322

Phone

(303) 333-7873

Fax

(303) 321-7873

NPI assigned

Aug 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Dermatology

Education

University of California, Irvine, California College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samantha Ghiselli MD PLLCGroup PAC ID 8820485261, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Samantha Ghiselli MD PLLC

  • Dermatology Physician
  • Glendale, CO
  • NPI 1689253734
  Medicare reassignment Care Compare group NPD
• Pure Dermatology PLLC

  • Dermatology Physician
  • Glendale, CO
  • NPI 1407363971
  Medicare reassignment NPD
• James H.Sternberg, M.D. a Medical Corporation

  • Procedural Dermatology Physician
  • Los Angeles, CA
  • NPI 1942317342

  Dermatopathology

  NPD (past)
• Murad Medical Group

  • Specialist
  • El Segundo, CA
  • NPI 1831154699
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1942212857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S CHERRY ST STE 310",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802461322",
            "telephone_number": "303-333-7873",
            "fax_number": "303-321-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S CHERRY ST STE 310",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802461322",
            "telephone_number": "303-333-7873",
            "fax_number": "303-321-7873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3613 Vista Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "92056",
            "country_code": "US",
            "telephone_number": "760-758-5340",
            "fax_number": "760-758-5502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHISELLI",
        "first_name": "SAMANTHA",
        "middle_name": "FAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A85337",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A85337",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A85337",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CO",
            "license": "51663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Jessica Gaines
• Galleria Wellness Center (timothy cymanski dc pc)
• Ryan Garrell, PHARMD
• Christopher David Gartland, D.D.S.
• Genoa Healthcare LLC
• John Kenneth Glade III, DC
• Lacey E Goergen, DDS
• Golden Peak Recovery
• Caitlin Elizabeth Grantham-Quirin, M.A., CF-SLP
• Sara Green

• MOHS-Micrographic Surgery Physician in Glendale, CO
• Providers in Glendale, CO by specialty
• MOHS-Micrographic Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.