Active NPI
Demosthenis Klonis, D.O.
- Cardiovascular Disease Physician
- Santa Fe, NM
National Provider Identifier
1124118500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- A-1319-05
- Practice address
- 465 Saint Michaels Dr
Suite 117
Santa Fe, NM 87505-7670 - Phone
- (505) 992-2600
- Fax
- (505) 992-2616
- NPI assigned
- Oct 13, 2006
- Last updated
- Apr 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | A-1319-05 | NM | Primary |
Addresses
Primary practice location
465 Saint Michaels Dr
Suite 117
Santa Fe, NM 87505-7670
Mailing address
PO Box 22130
Santa Fe, NM 87502-2130
Phone (575) 647-8366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29203708 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2792 | OK | MD | Optometrist |
| A-1319-05 | NM | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Mexico Cardiology & Arrythmia Consultants, PC | Cardiovascular Disease | Past | Accepting new patients |
| Eugene E. Langevin,D.O.,P.C. | Cardiovascular Disease | Past | Accepting new patients |
| Freeman-Oak Hill Health System | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Cardiovascular Disease Physician
- Las Cruces, NM
- NPI 1043306178
-
dba Cardiovascular Medicine
- Cardiovascular Disease Physician
- Joplin, MO
- NPI 1417144403
-
dba Freeman Physician Group
- Multi-Specialty Clinic/Center
- Joplin, MO
- NPI 1679517023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303344000000",
"number": "1124118500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22130",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875022130",
"telephone_number": "575-647-8366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 SAINT MICHAELS DR",
"address_2": "SUITE 117",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057670",
"telephone_number": "505-992-2600",
"fax_number": "505-992-2616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLONIS",
"first_name": "DEMOSTHENIS",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2011-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NM",
"license": "A-1319-05",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "29203708",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.