Individual provider Active NPI

David Levi Nathan, MD

  • Dermatology Physician
  • Avon, IN
National Provider Identifier
1619963998
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01051097 Issued in IN
Practice address
8244 E US Highway 36
Suite 1220
Avon, IN 46123-9613
Phone
(317) 272-1366
Fax
(317) 272-1388
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01051097 IN Primary

Addresses

Primary practice location

8244 E US Highway 36
Suite 1220
Avon, IN 46123-9613

Mailing address

8244 E US Highway 36
Suite 1220
Avon, IN 46123-9613
Phone (317) 272-1366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20070709000108 IN Practitioner - Dermatology 8729188677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Cincinnati College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8244 E US Hwy 36
Suite 1220
Avon, IN 46123-9613
Phone (317) 272-1366

8244 E US Hwy 36 1220
Avon, IN 46123-9613

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as individual
Quality
90
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision192
Removal of skin lesions735
Skin biopsy821

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Dermatology PC Dermatology CurrentSince Nov 1, 1999 Accepting new patients

Locations

8244 E US Highway 36
Ste 1220
Avon, IN 46123
Phone (317) 272-1366

Interoperability endpoints

  • Direct secure messaging: drnathan@compderm.azalea.phimailbox.com

Organizations & group practices 1

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 1

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1619963998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8244 E US HIGHWAY 36",
            "address_2": "SUITE 1220",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239613",
            "telephone_number": "317-272-1366",
            "fax_number": "317-272-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8244 E US HIGHWAY 36",
            "address_2": "SUITE 1220",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239613",
            "telephone_number": "317-272-1366",
            "fax_number": "317-272-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "DAVID",
        "middle_name": "LEVI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01051097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.