NPIMap

Individual provider Active NPI

Demetrios John Karamichos, MD

  • Family Medicine Physician
  • Munster, IN
National Provider Identifier
1376535146
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01064242A Issued in IN
Practice address
931 Ridge Rd Ste C
Munster, IN 46321-1756
Phone
(219) 595-3095
Fax
(219) 881-8776
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X 36093881 IL
Family Medicine Physician 207Q00000X 01064242A IN Primary

Addresses

Primary practice location

931 Ridge Rd Ste C
Munster, IN 46321-1756

Mailing address

931 Ridge Rd Ste C
Munster, IN 46321-1756
Phone (219) 595-3095

Other identifiers 3

IdentifierTypeStateIssuer
036093881MedicaidIL
P00721116OtherILMEDICARE RAILROAD
P00468376OtherINMEDICARE RAILROAD

Other names 1

  • Dr. Demetrios Karamichos Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080128000681 IN Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 4880615228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Vein Restoration in LLCGroup PAC ID 8426356528, 11 clinicians

Practice addresses (Care Compare)

931 Ridge Rd
Suite C
Munster, IN 46321-1756
Phone (219) 595-3095

9410 Calumet Ave
Suite 202
Munster, IN 46321-0018
Phone (855) 830-8346

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal621

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36093881ILMDPhlebology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Region Vein Phlebology CurrentSince Jun 16, 2020 Accepting new patients
Vein Clinics of Chicago LLC Past Accepting new patients

Locations

931 Ridge Rd
Ste C
Munster, IN 46321
Phone (219) 595-3095

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1376535146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 RIDGE RD STE C",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211756",
            "telephone_number": "219-595-3095",
            "fax_number": "219-881-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 RIDGE RD STE C",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211756",
            "telephone_number": "219-595-3095",
            "fax_number": "219-881-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARAMICHOS",
        "first_name": "DEMETRIOS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "IL",
            "license": "36093881",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01064242A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093881",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00721116",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00468376",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEMETRIOS",
            "last_name": "KARAMICHOS",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.