Individual provider Active NPI

Mark Adam Ramirez, MD

  • Dermatology Physician
  • San Angelo, TX
National Provider Identifier
1639373210
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M7551 Issued in TX
Practice address
3162 Appaloosa Cir
San Angelo, TX 76901-5225
Phone
(325) 224-5981
Fax
(325) 224-5981
NPI assigned
Jun 14, 2007
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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 M7551 TX Primary

Addresses

Primary practice location

3162 Appaloosa Cir
San Angelo, TX 76901-5225

Mailing address

PO Box 62701
San Angelo, TX 76906-2701
Phone (325) 224-5981

Other identifiers 2

IdentifierTypeStateIssuer
194490201MedicaidTX
8W2109OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080808000266 TX Practitioner - Dermatology 6608940630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 224-5981

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision194
Removal of skin lesions2248
Removal or shaving of skin growth220
Skin biopsy525

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7551TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Dermatology and Skin Cancer Center PLLC Dermatology CurrentSince Apr 22, 2014 Accepting new patients

Locations

3162 Appaloosa Cir
San Angelo, TX 76901
Phone (325) 658-4020

3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00323

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

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1639373210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62701",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769062701",
            "telephone_number": "325-224-5981",
            "fax_number": "325-224-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3162 APPALOOSA CIR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769015225",
            "telephone_number": "325-224-5981",
            "fax_number": "325-224-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "MARK",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M7551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194490201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8W2109",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.