Katina C Venetos, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Practice address

800 N Westmoreland Rd
Suite 100C
Lake Forest, IL 60045

Phone

(847) 234-1177

Fax

(847) 234-1875

NPI assigned

Aug 24, 2006

Last updated

Nov 7, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

Loyola University of Chicago, Stritch School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Woodruff Institute LLCGroup PAC ID 1658351101, 22 clinicians

Northshore Dermatology Center SCGroup PAC ID 5092807321, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score

95.7 of 100Reported as individual

Quality

91.41

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: venetos@northshore.emadirect.md

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.

• Northshore Dermatology Center SC

  dba Tina C Venetos MD

  • Dermatology Physician
  • Lake Bluff, IL
  • NPI 1841315884
  Medicare reassignment Care Compare group NPD
• Woodruff Institute LLC

  dba The Woodruff Institute

  • Dermatology Physician
  • Naples, FL
  • NPI 1558371195
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1336256437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 100C",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "60045",
            "telephone_number": "847-234-1177",
            "fax_number": "847-234-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 100C",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "60045",
            "telephone_number": "847-234-1177",
            "fax_number": "847-234-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENETOS",
        "first_name": "KATINA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01608107",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Unique Medical Imaging SC
• Samantha Jae Vaal, DPT, PTA, RYT-200
• Sharon Valencia, OTR/L
• Laura Lynn Valentine, DPT, OCS
• Shiney J. Varghese, DNP, FNP-BC
• Tanya Rose Verdoljak, M.A., CCC-SLP
• Denise Verges, MD
• Marissa Jane Versalle, DO
• Victoria Kut MD LTD
• David Vigder, MD

• Dermatology Physician in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.