Individual provider Active NPI

Jonathan Eric Webster

  • Dermatology Physician
  • Crestview Hills, KY
National Provider Identifier
1356802623
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
58022 Issued in KY
Practice address
651 Centre View Blvd
Crestview Hills, KY 41017-5419
Phone
(859) 371-3376
Fax
(859) 331-1053
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 58022 KY Primary

Addresses

Primary practice location

651 Centre View Blvd
Crestview Hills, KY 41017-5419

Mailing address

651 Centre View Blvd
Crestview Hills, KY 41017-5419
Phone (317) 278-6833

Other practice location 1

545 Barnhill Dr
Indianapolis, IN 46202-5112
Phone (317) 278-6833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230911002246 KY Practitioner - Dermatology 8022430503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

651 Centre View Boulvard
Crestview Hills, KY 41017-5419
Phone (859) 331-6466

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions455
Skin biopsy297

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58022KYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Aug 28, 2023 Accepting new patients
Summit Medical Group, Inc Dermatology CurrentSince Aug 28, 2023 Accepting new patients

Locations

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

7370 Turfway Rd
Florence, KY 41042
Phone (859) 212-5125

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1356802623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 CENTRE VIEW BLVD",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175419",
            "telephone_number": "317-278-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 CENTRE VIEW BLVD",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175419",
            "telephone_number": "859-371-3376",
            "fax_number": "859-331-1053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Barnhill Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025112",
            "country_code": "US",
            "telephone_number": "317-278-6833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "JONATHAN",
        "middle_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "58022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.