MARK DAVID MENICH (MD) – Allergy Physician, NPI 1417983438
Allergy Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
115 ALLERGY/IMMUNOLOGY in CO
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Provider Addresses for MARK DAVID MENICH (MD)
Broadway & 20th St, Broadway, Central Boulder - University Hill, Boulder, Boulder County, Colorado, 80309, United States
BOULDER VALLEY ASTHMA AND ALLERGY CLINICS
BOULDER, CO 803041104
Phone: (303) 444-5995
Fax: (303) 443-5030
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-01-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090819000784 | I | Allergy/Immunology | CO | TBD |
| I20171012003287 | I | Allergy/Immunology | KS | TBD |
| I20260115004268 | I | Allergy/Immunology | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 95004 | Test for allergy using allergenic extract | 1,246 | 29 | $0 |
| 95165 | Professional service for preparation and provision of 1 or more antigens | 295 | 15 | $0 |
| 95117 | Professional service for multiple injections of allergen | 236 | 55 | $0 |
| 95115 | Professional service for single injection of allergen | 180 | 42 | $0 |
| 95024 | Test for allergy using allergenic extract injected into skin | 61 | 12 | $0 |
Insurance plans in this area (ZIP 80304)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| - | TX | |
| - | TX | |
| - | TX | |
| Allergy/Immunology, Pediatric Medicine | TX | |
| A L L E R G Y/ I M M U N O L O G Y | TX |
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