Carl W Demidovich, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

33910 Issued in CO

Practice address

950 E Harvard Ave
Ste 440
Denver, CO 80210-7009

Phone

(303) 744-2704

Fax

(303) 744-3244

NPI assigned

Sep 2, 2006

Last updated

May 17, 2013By 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 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CO

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

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

Wright State University Boonshoft School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Colorado PCGroup PAC ID 8325337330, 65 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.78 of 100Reported as group

Quality

80

Promoting interoperability

84

Improvement activities

40

Cost

75.92

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.

• Advanced Dermatology of Colorado, PC

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1710370648
  Medicare reassignment Care Compare group NPD
• Denver Skin Clinic, P.C

  • Dermatology Physician
  • Denver, CO
  • NPI 1992824197
  NPD (past)
• Peter Grotuss MD PC

  dba Roaring Fork Dermatology

  • Dermatology Physician
  • Basalt, CO
  • NPI 1346384369
  NPD (past)
• Roaring Fork Dermatology Inc PC

  • Health Service Clinic/Center
  • Basalt, CO
  • NPI 1578746871
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1558463307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E HARVARD AVE",
            "address_2": "STE 440",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802107009",
            "telephone_number": "303-744-2704",
            "fax_number": "303-744-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E HARVARD AVE",
            "address_2": "STE 440",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802107009",
            "telephone_number": "303-744-2704",
            "fax_number": "303-744-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIDOVICH",
        "first_name": "CARL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "33910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01339100",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070015071",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19292",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "84-1511239",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Demay, NP
• Rachel Anne Demby, MD
• Delilah Demers
• Nathaan Demers, M.A.
• Demes Therapy LLC
• Shumet Demie
• Demir Express LLC
• Demir Express LLC
• Demir LLC
• Katalina Berrin Demirkol

• Dermatology Physician in Denver, CO
• Providers in Denver, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.