Alexander Demetre Nicoloff, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

18926 Issued in OR

Practice address

501 N Graham St
Suite 415
Portland, OR 97227-1654

Phone

(503) 413-3580

Fax

(503) 413-3578

NPI assigned

Feb 28, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Merit-based Incentive Payment System (MIPS)

Final score

85.76 of 100Reported as group

Quality

88.93

Promoting interoperability

93

Improvement activities

40

Cost

69.42

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Inovia LLC

  • Vascular Surgery Physician
  • Bend, OR
  • NPI 1376753442
  Medicare reassignment NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Vascular Surgery

  Medicare reassignment NPD
• Mt Hood General and Vascular Surgeons LLC

  • Vascular Surgery Physician
  • Lake Oswego, OR
  • NPI 1710106687
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1386610277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 415",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-413-3580",
            "fax_number": "503-413-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 415",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-413-3580",
            "fax_number": "503-413-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLOFF",
        "first_name": "ALEXANDER",
        "middle_name": "DEMETRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OR",
            "license": "18926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226934",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Brown Prof Corp
• Nicole Holton, DC, PC
• Andrea Nicolet
• Daniel Patrick Nicoli, DO
• Roslyn Nicoll
• Ron Nida
• Mary Anne Joseph Nidiry, MD
• Dolores A Niebergall, PT
• Kimberly Catherine Nieblas, AUD
• Edouard Niedenthal Duret

• Vascular Surgery Physician in Portland, OR
• Providers in Portland, OR by specialty
• Vascular Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.