Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jason Ryan Mammino

Individual provider Dermatology Physician · NPI 1548757073

Jason Ryan Mammino is a Dermatology in Castle Rock, Colorado. Qualified in 2018, 8 years ago. Practices with Advanced Dermatology of Colorado PC, a 64-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
8
Licensed in
CO
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

4344 Woodlands Blvd Ste 160
Castle Rock, CO 80104-2801
Phone: (303) 350-4500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 0066760 (CO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1548757073
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 19, 2018
Last updated in NPPESMay 1, 2023
Certification dateMay 1, 2023
Mailing address4344 Woodlands Blvd Ste 160, Castle Rock, CO 80104-2801

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Also practisesOSTEOPATHIC MANIPULATIVE MEDICINE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Advanced Dermatology Of Colorado Pc — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Castle Rock