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SAGE DERMATOLOGY LLC
NPI 1255002101
Dermatology in Loveland, CO

Active since September 21, 2021CLIA Certified · 2 labs
1548 BOISE AVE, LOVELAND, CO 80538(970) 682-3377(970) 682-3340 Get Directions Write a Review

NPPES record last updated: November 1, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 1, 2021, Sep 21, 2021 (2 updates tracked since 2021).

About Sage Dermatology Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAGE DERMATOLOGY LLC (NPI 1255002101) is a healthcare organization registered as a dermatology in Loveland, Colorado and active in the NPI registry since September 2021. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Laramie, and lists Samuel Ecker, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1255002101
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSAGE DERMATOLOGY LLC
Location Address1548 BOISE AVELoveland, CO 80538-4215
Mailing Address2710 Westridge CtFort Collins, CO 80526-6503 · (970) 682-3377 · Fax (970) 682-3340
Phone(970) 682-3377
Fax(970) 682-3340
Organization SubpartNo
Authorized OfficialSamuel EckerMd/owner · (970) 682-3377
Enumeration DateSeptember 21, 2021
Last NPPES UpdateNovember 1, 20212 updates tracked since enumeration
NPPES CertifiedNovember 1, 2021
✔ NPI 1255002101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1548 BOISE AVE, Loveland, CO 80538
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Secondary Practice Location 1

Location 1204 McCollum St Ste 106ELaramie, WY 82070-5151 · Phone (970) 682-3377 · Fax (970) 682-3340

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sage Dermatology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Sage Dermatology LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Bruce Kornfeld, M.D.
Dermatology
NPI 1326074774
1907 BOISE AVE
Loveland, CO 80538
(970) 682-3377
✔ PECOS✔ Accepts Medicare0.3 mi
Samuel Ecker, D.O.
Dermatology
NPI 1033555230
204 MCCOLLUM ST STE 106E
Laramie, WY 82070
(970) 682-3377
✔ PECOS✔ Accepts Medicare68 mi
Jordan Fabrikant, D.O.
Dermatology
NPI 1649585753
921 TOWN CENTER DR
Orange City, FL 32763
(386) 218-1180
✔ PECOS✔ Accepts Medicare1,561 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 06D2301712

Sage Dermatology · Windsor, CO
Active · expires Mar 18, 2027
CLIA Number06D2301712
Laboratory TypePhysician Office
Certificate Effective DateMarch 19, 2025
Certificate Expiration DateMarch 18, 2027
Laboratory DirectorDr. Samuel B. Ecker
Laboratory Phone(970) 682-3377
Laboratory LocationSage Dermatology1555 Main St, Unit A-6, Windsor, CO 80550
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 53D2265113

Sage Dermatology · Laramie, WY
Active · expires Oct 16, 2028
CLIA Number53D2265113
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2026
Certificate Expiration DateOctober 16, 2028
Laboratory DirectorSamuel B. Ecker
Laboratory Phone(307) 395-3376
Laboratory LocationSage Dermatology204 Mccollum St, Ste 107, Laramie, WY 82070
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sage Dermatology LLC's NPI number?

The NPI number for Sage Dermatology LLC is 1255002101. It was assigned to this organization in the NPPES registry on September 21, 2021.

Where is Sage Dermatology LLC located?

Sage Dermatology LLC is located at 1548 Boise Ave, Loveland, CO 80538. The listed phone number is (970) 682-3377.

What is Sage Dermatology LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Sage Dermatology LLC enrolled in Medicare?

Yes. Sage Dermatology LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sage Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Dermatology, reassign their Medicare billing to Sage Dermatology LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Sage Dermatology LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Sage Dermatology LLC accept?

Health plans from Blue Cross Blue Shield of Wyoming list Sage Dermatology LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sage Dermatology LLC was last updated on November 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.