Individual provider Active NPI

Michael Alexander Demos, M.D.

  • Cardiovascular Disease Physician
  • Durango, CO
National Provider Identifier
1639144975
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
19115 Issued in CO
Practice address
1 Mercado St
Ste 130
Durango, CO 81301-7306
Phone
(970) 247-1120
Fax
(970) 247-1128
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 19115 CO Primary

Addresses

Primary practice location

1 Mercado St
Ste 130
Durango, CO 81301-7306

Mailing address

1 Mercado St
Ste 130
Durango, CO 81301-7306
Phone (970) 247-1120

Other identifiers 1

IdentifierTypeStateIssuer
91500207MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19115COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Radial First Holdings Past Accepting new patients
Teton Cardiovascular and Pulmonary Lab,LLC PastSince May 11, 2025 Accepting new patients

Organizations & group practices 2

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1639144975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "STE 130",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017306",
            "telephone_number": "970-247-1120",
            "fax_number": "970-247-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "STE 130",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017306",
            "telephone_number": "970-247-1120",
            "fax_number": "970-247-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOS",
        "first_name": "MICHAEL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "19115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91500207",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.