SKIN PC
NPI 1356124416
Dermatology in Louisville, CO

Active since August 14, 2023
335 W SOUTH BOULDER RD STE 3, LOUISVILLE, CO 80027(970) 667-3116(970) 669-0159 Get Directions Write a Review

NPPES record last updated: August 14, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Skin Pc NPPES

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

SKIN PC (NPI 1356124416), doing business as Ideal Dermatology, is a healthcare organization registered as a dermatology in Louisville, Colorado and active in the NPI registry since August 2023. The organization lists Kevin John Mott, Authorized Rep, as its authorized official.

NPPES Registry Identity

NPI1356124416
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSKIN PC
Location Address335 W SOUTH BOULDER RD STE 3Louisville, CO 80027-1192
Mailing AddressPo Box 7065Loveland, CO 80537-0065 · (970) 667-3116 · Fax (970) 669-0159
Fax(970) 669-0159
Organization SubpartNo
Authorized OfficialKevin John MottAuthorized Rep · (303) 569-7700
Enumeration DateAugust 14, 2023
NPPES CertifiedAugust 14, 2023
✔ NPI 1356124416 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.
335 W SOUTH BOULDER RD STE 3, Louisville, CO 80027

Other Names 1

Doing Business AsIdeal Dermatology

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Skin Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Skin PC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Dermatology
NPI 1548729791
905 ALPINE AVE
Boulder, CO 80304
(970) 667-3116
✔ PECOS✔ Accepts Medicare9.3 mi
Dermatology
NPI 1295776201
1708 BOISE AVE
Loveland, CO 80538
(970) 667-3116
✔ PECOS✔ Accepts Medicare29 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

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 06D2099836

Skin, PC Dba Ideal Dermatology · Boulder, CO
Expired · Sep 30, 2026
CLIA Number06D2099836
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorKevin J. Mott
Laboratory Phone(970) 667-3116
Laboratory LocationSkin, PC Dba Ideal Dermatology905 Alpine Ave, Boulder, CO 80304
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.

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 Skin PC's NPI number?

The NPI number for Skin PC is 1356124416. It was assigned to this organization in the NPPES registry on August 14, 2023. The provider is doing business as Ideal Dermatology.

Where is Skin PC located?

Skin PC is located at 335 W South Boulder Rd Ste 3, Louisville, CO 80027. The listed phone number is (970) 667-3116.

What is Skin PC's specialty?

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

Is Skin PC enrolled in Medicare?

Yes. Skin PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Skin PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Skin PC. 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.

When was this NPI record last updated?

The NPPES record for Skin PC was last updated on August 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.