Mark C Demetrios, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

COA 14997-NP Issued in OH

Practice address

955 Windham CT
Suite 2
Boardman, OH 44512-5035

Phone

(330) 726-9570

NPI assigned

Aug 19, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Psychiatry Group IncGroup PAC ID 6406932144, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdemetrios@276623a4.micromddirect.com

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.

• Comprehensive Psychiatry Group Inc

  • Social Worker
  • Boardman, OH
  • NPI 1023293198
  Medicare reassignment Care Compare group NPD
• Family & Community Services Inc

  dba Valley Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, OH
  • NPI 1750607057
  Medicare reassignment NPD
• Family & Community Services, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Kent, OH
  • NPI 1952662108
  NPD
• Comprehensive Psychiatry Group, Inc.

  • Social Worker
  • Boardman, OH
  • NPI 1750539045
  NPD (past)

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1285067801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 WINDHAM CT",
            "address_2": "SUITE 2",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125035",
            "telephone_number": "330-726-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 WINDHAM CT",
            "address_2": "SUITE 2",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125035",
            "telephone_number": "330-726-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRIOS",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "COA 14997-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Delcalzo
• Kelsey Marie Demart, LPCC
• Theresanne Demartino Ringler, DO, MS
• Nicole M Dematteis, CDCA
• Deandra Demes, OT
• Angie Denicholas
• Dennis P Orr II DO LLC
• Dental Express Boardman, Ted a Schuster DDS LLC
• Desai G. Krishna-Rao (Boardman Allergy Associates)
• David Paul Desantis, D.C.

• Psychiatric/Mental Health Nurse Practitioner in Boardman, OH
• Providers in Boardman, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.

Verify at the official NPI Registry.