Active NPI
Olga Demidova, DO
- MOHS-Micrographic Surgery Physician
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- MOHS-Micrographic Surgery Physician
- License
- 34.01294
- Practice address
- 9724 N Armenia Ave Ste 300
Tampa, FL 33612-7550 - Phone
- (216) 804-5996
- Fax
- (216) 758-4783
- NPI assigned
- Mar 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | OS14719 | FL | |
| Dermatology Physician | 207N00000X | 34.012494 | OH | |
| MOHS-Micrographic Surgery Physician | 207ND0101X | 34.01294 | OH | Primary |
| Dermatology Physician | 207N00000X | OS14719 | FL |
Addresses
Primary practice location
9724 N Armenia Ave Ste 300
Tampa, FL 33612-7550
Mailing address
9724 N Armenia Ave Ste 300
Tampa, FL 33612-7550
Phone (216) 804-5996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Ohio University, College of Osteopathic Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS14719 | FL | MD | MOHS-Micrographic Surgery Physician |
| 34.01294 | OH | MD | MOHS-Micrographic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Metrohealth System | Multi-Specialty | Current | Accepting new patients |
| The Metrohealth System | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients | |
| Mason Dermatology Center Inc | Multi-Specialty | Past | Accepting new patients |
| Western Reserve Dermatology, Inc | Multi-Specialty | Past | Accepting new patients |
Locations
2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348
4229 Pearl Rd
Cleveland, OH 44109
Phone (216) 459-6300
Interoperability endpoints
- odemidova166248@direct.metrohealth.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Metrohealth Professional Group
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1053353896
-
- MOHS-Micrographic Surgery Physician
- Tampa, FL
- NPI 1336899061
-
dba Metrohealth Medical Center
- General Acute Care Hospital
- Cleveland, OH
- NPI 1700828852
-
dba MetroHealth Brooklyn Memphis Pharmacy
- Pharmacy
- Cleveland, OH
- NPI 1992529911
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Metrohealth Life Flight
- Air Ambulance
- Cleveland, OH
- NPI 1609043645
Hospital
-
dba Metrohealth Medical Center
- General Acute Care Hospital
- Cleveland, OH
- NPI 1700828852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780531200000",
"number": "1174915987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9724 N ARMENIA AVE STE 300",
"city": "TAMPA",
"state": "FL",
"postal_code": "336127550",
"telephone_number": "216-804-5996",
"fax_number": "216-758-4783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9724 N ARMENIA AVE STE 300",
"city": "TAMPA",
"state": "FL",
"postal_code": "336127550",
"telephone_number": "216-804-5996",
"fax_number": "216-758-4783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMIDOVA",
"first_name": "OLGA",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-03",
"last_updated": "2026-06-04",
"certification_date": "2026-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "FL",
"license": "OS14719",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OH",
"license": "34.012494",
"primary": false
},
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "OH",
"license": "34.01294",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": "FL",
"license": "OS14719",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.