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BOULDER DERMATOLOGY
NPI 1790145183
Dermatology in Boulder, CO

Active since February 29, 2016
3575 BROADWAY ST, BOULDER, CO 80304(303) 449-0933 Get Directions Write a Review

NPPES record last updated: January 14, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 14, 2019, Feb 29, 2016 (2 updates tracked since 2016).

About Boulder Dermatology NPPES

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

BOULDER DERMATOLOGY (NPI 1790145183) is a healthcare organization registered as a dermatology in Boulder, Colorado and active in the NPI registry since February 2016. The organization lists Adam S Plotkin, Signor, as its authorized official.

NPPES Registry Identity

NPI1790145183
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF BOULDER CREEK, LLC
Location Address3575 BROADWAY STBoulder, CO 80304-1825
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000
Phone(303) 449-0933
Organization SubpartNo
Authorized OfficialAdam S PlotkinSignor · (561) 314-2000
Enumeration DateFebruary 29, 2016
Last NPPES UpdateJanuary 14, 20192 updates tracked since enumeration
✔ NPI 1790145183 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.
3575 BROADWAY ST, Boulder, CO 80304
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Other Names 1

Doing Business AsBoulder Dermatology

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Boulder Dermatology 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 Boulder Dermatology, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Todd Becker, M.D., PH.D.
Dermatology
NPI 1508049206
2600 30TH ST STE 100
Boulder, CO 80301
(303) 444-0664
✔ PECOS✔ Accepts Medicare1.8 mi
Allison Morrison, MD
Dermatology
NPI 1063613826
1551 PROFESSIONAL LN SUITE 135
Longmont, CO 80501
(303) 532-2810
✔ PECOS✔ Accepts Medicare12 mi
Megan Waite, M.D.
Dermatology
NPI 1487946612
3003 W GOOD HOPE RD
Milwaukee, WI 53209
(414) 352-3100
✔ PECOS✔ Accepts Medicare921 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 06D0678429

Integrated Dermatology Of Boulder Creek, PLLC · Boulder, CO
Expired · Sep 30, 2026
CLIA Number06D0678429
Laboratory TypePhysician Office
Certificate Effective DateSeptember 13, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorDr. Todd Becker
Laboratory Phone(303) 449-0933
Laboratory LocationIntegrated Dermatology Of Boulder Creek, PLLC3575 Broadway, Boulder, CO 80304
CLIA data matches this NPI record on: Address 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 Integrated Dermatology Of Boulder Creek, LLC's NPI number?

The NPI number for Integrated Dermatology Of Boulder Creek, LLC is 1790145183. It was assigned to this organization in the NPPES registry on February 29, 2016. The provider is doing business as Boulder Dermatology.

Where is Integrated Dermatology Of Boulder Creek, LLC located?

Integrated Dermatology Of Boulder Creek, LLC is located at 3575 Broadway St, Boulder, CO 80304. The listed phone number is (303) 449-0933.

What is Integrated Dermatology Of Boulder Creek, LLC's specialty?

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

Is Integrated Dermatology Of Boulder Creek, LLC enrolled in Medicare?

Yes. Integrated Dermatology Of Boulder Creek, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Integrated Dermatology Of Boulder Creek, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Dermatology, reassign their Medicare billing to Integrated Dermatology Of Boulder Creek, 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.

When was this NPI record last updated?

The NPPES record for Integrated Dermatology Of Boulder Creek, LLC was last updated on January 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.