Divine Dermatology and Surgical Institute, PLLC
NPI 1215460290 · Medical Specialty Clinic/Center · Fort Collins, CO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Divine Dermatology and Surgical Institute, PLLC is a Medical Specialty Clinic/Center organization in Fort Collins, CO (NPI 1215460290).
Provider details
- NPI number
- 1215460290
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jennifer Divine, Owner(970) 388-2850
- License
- DR.0058205 (CO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-04-06
- Last updated
- 2024-09-10
- Certified
- 2024-09-10
Frequently asked questions
- What is Divine Dermatology and Surgical Institute, PLLC's NPI number?
- Divine Dermatology and Surgical Institute, PLLC's National Provider Identifier (NPI) is 1215460290, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Divine Dermatology and Surgical Institute, PLLC?
- Divine Dermatology and Surgical Institute, PLLC is classified in the NPPES registry as Medical Specialty Clinic/Center (Ambulatory Health Care Facilities).
- Where is Divine Dermatology and Surgical Institute, PLLC located?
- Divine Dermatology and Surgical Institute, PLLC's practice location on file with NPPES is 1260 Doctors Ln, Fort Collins, CO 80524-4038.
- What is Divine Dermatology and Surgical Institute, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Divine Dermatology and Surgical Institute, PLLC is (813) 765-8453.
- Does Divine Dermatology and Surgical Institute, PLLC accept Medicare?
- Divine Dermatology and Surgical Institute, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Divine Dermatology and Surgical Institute, PLLC?
- The authorized official listed on Divine Dermatology and Surgical Institute, PLLC's NPPES record is Jennifer Divine, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Divine Dermatology and Surgical Institute, PLLC's NPI active?
- Yes — Divine Dermatology and Surgical Institute, PLLC's NPI (1215460290) is active in the NPPES registry as of the last update on 2024-09-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.