John Robert West Jr., M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

44204 Issued in CT

Practice address

34 Water Street
Suite 2
Mystic, CT 06355

Phone

(860) 572-9994

Fax

(860) 572-9930

NPI assigned

May 17, 2006

Last updated

Oct 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Dermatology

Education

University of California, San Diego School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John R. West MD IncGroup PAC ID 5092719484, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
• Westerly Hospital Hospital, Westerly, RI, CCN 410013

Merit-based Incentive Payment System (MIPS)

Final score

72.39 of 100Reported as group

Quality

82.52

Improvement activities

40

Cost

31.29

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John R. West MD Inc

  dba Seaport Dermatology

  • MOHS-Micrographic Surgery Physician
  • Mystic, CT
  • NPI 1376575324
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879
  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1700092459
  Care Compare affiliation
• LMW Healthcare Inc.

  dba Westerly Hospital

  • General Acute Care Hospital
  • Westerly, RI
  • NPI 1447595368
  Care Compare affiliation

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1487606117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 WATER STREET",
            "address_2": "SUITE 2",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-9994",
            "fax_number": "860-572-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 WATER STREET",
            "address_2": "SUITE 2",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-9994",
            "fax_number": "860-572-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "G61079",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CT",
            "license": "44204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "010044204CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy David Wano, D.M.D
• James Paul Watts, DMD
• Neal Weisbrod
• Jennifer Louise Welch, D.C.
• Edmund A P West, MD
• Laura Ann White, OTRL
• Miriam Wholean, MSW, LCSW
• Wholeness Insight Psychotherapy LLC
• Shaina Dawn Wilkinson, MSW, LMSW,LCSW
• Amanda Williams, BCBA, LBA

• MOHS-Micrographic Surgery Physician in Mystic, CT
• Providers in Mystic, CT by specialty
• MOHS-Micrographic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.