Individual provider Active NPI

Rui G Demelo, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Stamford, CT
National Provider Identifier
1184612855
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
000783 Issued in CT
Practice address
1234 Summer St Ste 202
Stamford, CT 06905-5510
Phone
(203) 323-1171
Fax
(203) 323-4649
NPI assigned
Oct 7, 2005
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 000783 CT Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 000783 CT

Addresses

Primary practice location

1234 Summer St Ste 202
Stamford, CT 06905-5510

Mailing address

1234 Summer St Ste 202
Stamford, CT 06905-5510
Phone (203) 323-1171

Other identifiers 4

IdentifierTypeStateIssuer
030000783CT01OtherCTBLUE CROSS
95809OtherCTAETNA
2V4758OtherCTHEALTHNET
P3064982OtherCTOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031223000502 CT Practitioner - Podiatry 8921906207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stamford Podiatry Group PCGroup PAC ID 8022916394, 2 clinicians

Practice addresses (Care Compare)

1234 Summer St
Suite 202
Stamford, CT 06905-5510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions68
Removal of nail tissue529
Removal or shaving of skin growth95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000783CTMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Podiatry Group PC Primary Podiatric Medicine CurrentSince Oct 1, 2003 Accepting new patients
Stamford Podiatry Group PC Primary Podiatric Medicine CurrentSince Oct 1, 2003 Accepting new patients

Locations

1234 Summer St
Ste 202
Stamford, CT 06905
Phone (203) 323-1171

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1184612855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 SUMMER ST STE 202",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055510",
            "telephone_number": "203-323-1171",
            "fax_number": "203-323-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 SUMMER ST STE 202",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055510",
            "telephone_number": "203-323-1171",
            "fax_number": "203-323-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMELO",
        "first_name": "RUI",
        "middle_name": "G",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CT",
            "license": "000783",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "000783",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "030000783CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "95809",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V4758",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3064982",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.