Active NPI 1760604276 Individual Practitioner Male Practitioner

Dr. William Sean Burke , MD

Dermatology • Evergreen, CO

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. William Burke, MD is a certified Dermatology practicing in Evergreen, CO. With approximately 21 years of clinical experience since graduating from Illinois Medical College in 2005, Dr. Burke delivers high-quality medical care to the local community at 2942 EVERGREEN PKWY STE 100.

Dr. Burke accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, new patient outpatient office visit, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2942 Evergreen Pkwy Ste 100

Evergreen, CO 804397909

Telephone 7208369981

Fax 7203869132

Associated Practice Facility / Clinic

🏢 Burke Dermatology Sc Facility NPI 1295976256

Medicare Profile & Education

Medical School

Illinois Medical College

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Evergreen, CO

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

21 Yrs Matches City Avg

City Avg: 21.0 Yrs

State Avg: 19.3 Yrs

Regional Practice Density

1 Specialists

Practicing in Evergreen, CO (321 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

43.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Burke (21 Years) 21 Yrs

Evergreen Specialty Average (21.0 Years) 21.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	259	54	$11.44	$6.83
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	114	113	$187.16	$112.10
99213 Established patient office or other outpatient visit, typically 15 minutes	108	81	$149.34	$91.32
17000 Destruction of skin growth	94	78	$115.31	$51.72
17110 Destruction of up to 14 skin growths	80	66	$194.90	$110.82
11102 Tangential biopsy of single skin lesion	70	58	$171.60	$91.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	64	40	$95.58	$57.18
99202 New patient office or other outpatient visit, typically 20 minutes	36	36	$121.50	$72.93
11103 Biopsy of related skin growth, each additional growth	19	14	$85.31	$50.92
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	16	15	$518.26	$289.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	146	27	$12.69	$6.95
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	81	81	$194.19	$112.22
17000 Destruction of skin growth	54	42	$121.32	$51.82
17110 Destruction of up to 14 skin growths	53	48	$207.34	$112.50
99213 Established patient office or other outpatient visit, typically 15 minutes	45	34	$149.33	$88.94
11102 Tangential biopsy of single skin lesion	37	31	$179.71	$95.49
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	19	$98.01	$57.31
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$122.76	$73.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	75	12	$29.00	$7.08
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$175.00	$113.40
17000 Destruction of skin growth	17	13	$140.00	$53.05
17110 Destruction of up to 14 skin growths	12	11	$210.00	$118.70
11102 Tangential biopsy of single skin lesion	11	11	$170.00	$107.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,054	234	$22.74	$6.44
99213 Established patient office or other outpatient visit, typically 15 minutes	635	567	$127.73	$91.03
17000 Destruction of skin growth	392	352	$126.48	$53.13
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	276	268	$106.43	$55.36
11102 Tangential biopsy of single skin lesion	250	227	$164.82	$94.28
17110 Destruction of up to 14 skin growths	237	229	$200.20	$109.57
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	113	113	$161.59	$113.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	92	89	$175.00	$126.84
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	72	19	$4.58	$1.32
11103 Biopsy of related skin growth, each additional growth	53	37	$91.68	$52.17
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	41	36	$1080.00	$605.67
99202 New patient office or other outpatient visit, typically 20 minutes	38	38	$135.11	$72.66
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	35	32	$497.60	$290.40
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	34	26	$535.76	$138.55
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	32	22	$650.00	$400.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	32	32	$240.00	$163.15
17004 Destruction of precancer skin growth, 15 or more growths	29	26	$310.14	$165.82
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	28	27	$428.57	$235.41
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	25	24	$411.08	$123.29
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	25	24	$417.72	$249.87
11200 Removal of skin tag, 1-15 skin tags	21	21	$156.00	$60.61
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	19	17	$472.42	$291.33
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	14	11	$279.14	$145.66
17111 Destruction of skin growth, 15 or more growths	13	13	$240.00	$129.40
11900 Injection into skin growth, 1-7 growths	12	11	$90.42	$47.48
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	12	11	$436.00	$126.63
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	12	11	$485.00	$141.47
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	11	11	$470.00	$296.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,135	234	$29.00	$5.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	664	552	$95.02	$44.41
99213 Established patient office or other outpatient visit, typically 15 minutes	489	426	$120.02	$74.01
17000 Destruction of skin growth	443	370	$140.00	$52.92
17110 Destruction of up to 14 skin growths	259	241	$210.00	$105.22
11102 Tangential biopsy of single skin lesion	255	220	$170.00	$88.60
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	94	80	$1080.00	$607.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	74	74	$160.00	$106.70
99202 New patient office or other outpatient visit, typically 20 minutes	74	74	$135.00	$74.74
11103 Biopsy of related skin growth, each additional growth	72	49	$95.00	$52.09
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	60	56	$520.00	$271.88
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	51	48	$480.00	$206.26
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	50	48	$558.00	$133.93
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	48	33	$650.00	$390.44
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	44	42	$430.00	$234.78
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	41	38	$425.00	$123.75
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	38	14	$5.00	$1.44
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	37	36	$420.00	$223.77
11200 Removal of skin tag, 1-15 skin tags	32	31	$156.00	$65.66
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	30	28	$225.67	$121.21
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	24	24	$243.00	$168.34
17004 Destruction of precancer skin growth, 15 or more growths	20	17	$348.00	$155.26
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	17	17	$260.00	$158.50
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	16	$444.00	$164.83
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	15	13	$256.00	$80.56
11104 Punch biopsy, first skin growth	14	14	$215.00	$122.92
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	13	12	$519.00	$149.71
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	11	$300.00	$84.01
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	11	11	$708.00	$273.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,179	236	$29.00	$5.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	781	637	$85.00	$43.32
99213 Established patient office or other outpatient visit, typically 15 minutes	508	437	$105.00	$71.49
17000 Destruction of skin growth	484	391	$140.00	$52.15
11102 Tangential biopsy of single skin lesion	356	309	$170.00	$87.26
17110 Destruction of up to 14 skin growths	139	135	$210.00	$102.99
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	124	108	$1080.00	$597.35
11103 Biopsy of related skin growth, each additional growth	93	66	$95.00	$50.93
99202 New patient office or other outpatient visit, typically 20 minutes	80	80	$125.00	$73.91
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	71	52	$650.00	$378.47
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	68	19	$5.00	$1.57
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	67	61	$480.00	$206.75
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$150.00	$105.25
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	63	62	$520.00	$286.64
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	51	45	$558.00	$178.69
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	39	38	$425.00	$144.99
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	38	36	$430.00	$145.24
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	30	30	$420.00	$169.66
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	28	26	$247.00	$140.29
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	27	26	$243.00	$158.17
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	25	21	$207.00	$114.46
11200 Removal of skin tag, 1-15 skin tags	22	22	$156.00	$70.06
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	22	22	$444.00	$203.70
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	16	13	$225.00	$119.48
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$300.00	$81.27
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	15	$519.00	$146.58
17004 Destruction of precancer skin growth, 15 or more growths	15	14	$348.00	$146.99
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	15	15	$256.00	$169.74
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	14	13	$480.00	$165.19
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	13	12	$290.00	$176.99
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	12	11	$521.00	$231.62
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	12	11	$708.00	$247.03
11104 Punch biopsy, first skin growth	12	11	$215.00	$113.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,112	218	$29.00	$5.08
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	794	642	$75.00	$42.17
99213 Established patient office or other outpatient visit, typically 15 minutes	471	414	$96.00	$70.58
17000 Destruction of skin growth	400	333	$140.00	$56.52
11100 Biopsy of single growth of skin and/or tissue	343	301	$181.00	$98.08
99202 New patient office or other outpatient visit, typically 20 minutes	137	137	$115.00	$71.78
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	115	96	$1080.00	$567.22
11101 Biopsy of each additional growth of skin and/or tissue	105	62	$97.00	$31.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	105	105	$147.00	$104.43
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	72	50	$650.00	$374.96
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	70	67	$510.00	$266.41
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	54	52	$480.00	$204.62
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	51	16	$5.00	$1.84
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	43	39	$558.00	$168.71
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	42	38	$207.00	$121.00
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	38	37	$420.00	$132.84
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	37	37	$430.00	$153.10
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	33	30	$247.00	$136.52
17004 Destruction of precancer skin growth, 15 or more growths	27	25	$348.00	$140.16
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	25	25	$400.00	$202.10
17110 Destruction of up to 14 skin growths	25	22	$200.00	$101.94
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	23	22	$519.00	$144.32
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	19	18	$243.00	$148.59
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	18	17	$521.00	$195.27
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$300.00	$80.74
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	16	16	$460.00	$236.63
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	15	$444.00	$140.01
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	15	14	$2107.00	$761.36
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	15	11	$256.00	$77.29
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	13	13	$225.00	$140.17
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	13	12	$256.00	$160.20
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	13	12	$290.00	$175.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,376	277	$29.00	$5.40
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	935	755	$75.00	$41.72
99213 Established patient office or other outpatient visit, typically 15 minutes	559	477	$96.00	$70.11
17000 Destruction of skin growth	486	410	$140.00	$58.75
11100 Biopsy of single growth of skin and/or tissue	287	255	$181.00	$95.41
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	142	37	$5.00	$1.82
99202 New patient office or other outpatient visit, typically 20 minutes	141	141	$115.00	$71.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	119	119	$147.00	$104.79
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	114	108	$1080.00	$573.46
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	61	59	$480.00	$211.13
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	59	43	$650.00	$367.80
11101 Biopsy of each additional growth of skin and/or tissue	52	44	$97.00	$31.97
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	49	48	$510.00	$269.21
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	47	43	$558.00	$164.31
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	35	34	$430.00	$136.36
11900 Injection into skin growth, 1-7 growths	30	23	$100.00	$47.30
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	28	26	$207.00	$112.38
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	23	22	$247.00	$153.16
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	22	21	$420.00	$124.55
17110 Destruction of up to 14 skin growths	19	18	$200.00	$101.98
17004 Destruction of precancer skin growth, 15 or more growths	18	18	$348.00	$143.98
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	17	16	$519.00	$136.87
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	16	16	$400.00	$198.82
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	16	16	$2107.00	$757.67
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	15	13	$243.00	$148.48

Medical Specialties & State Licenses

CMS Verified: 2025-05-26

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License IL 125-049888

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Business Mailing Address May 26, 2025

Registered at 2942 EVERGREEN PKWY STE 100, EVERGREEN, CO 804397909 (Tel: 7208369981)

📍

Updated Practice Location April 13, 2022

Registered at 2942 EVERGREEN PKWY STE 100, EVERGREEN, CO 804397909 (Tel: 7208369981)

📍

Updated Business Mailing Address April 13, 2022

Registered at 32530 ALPINE LN, EVERGREEN, CO 804397942 (Tel: 7208369981)

✅

NPI Profile Active July 15, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location July 15, 2011

Registered at 600 N GIANT CITY RD, CARBONDALE, IL 629026418 (Tel: 6185492500)

📍

Updated Business Mailing Address July 15, 2011

Registered at 600 N GIANT CITY RD, CARBONDALE, IL 629026418 (Tel: 6185492500)

👤

Provider Name / Credentials Updated July 15, 2011

Recorded as WILLIAM BURKE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 15, 2011

Dermatology (License #125-049888 in IL)

🟢

Initial NPI Registration & Enumeration May 03, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1760604276

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 03, 2007

Last Update: May 26, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2942 Evergreen Pkwy Ste 100

Evergreen, CO 804397909

Phone: 7208369981

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.