Individual provider Active NPI

Christopher John Remishofsky, MD

  • Dermatology Physician
  • Sterling Heights, MI
National Provider Identifier
1649487984
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301084290 Issued in MI
Practice address
39242 Dequindre Rd
Suite 105
Sterling Heights, MI 48310-1764
Phone
(586) 979-1750
NPI assigned
May 17, 2007
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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 4301084290 MI Primary

Addresses

Primary practice location

39242 Dequindre Rd
Suite 105
Sterling Heights, MI 48310-1764

Mailing address

39242 Dequindre Rd
Suite 105
Sterling Heights, MI 48310-1764
Phone (586) 979-1750

Other identifiers 1

IdentifierTypeStateIssuer
P47710003OtherMIMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080318000399 MI Practitioner - Dermatology 6709962616 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
Group practices
Georgetown Dermatologists, P.C.Group PAC ID 6608960877, 2 clinicians

Practice addresses (Care Compare)

39242 Dequindre Rd
Suite 105
Sterling Heights, MI 48310-1767
Phone (586) 979-1750

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions2111
Removal of nail tissue1-10
Removal or shaving of skin growth269
Skin biopsy14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301084290MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgetown Dermatologists, P.C. CurrentSince Feb 9, 2008 Accepting new patients

Locations

39242 Dequindre Rd
Sterling Heights, MI 48310
Phone (586) 446-8060

39242 Dequindre Rd
Ste 105
Sterling Hts, MI 48310
Phone (586) 979-1750

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1649487984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39242 DEQUINDRE RD",
            "address_2": "SUITE 105",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483101764",
            "telephone_number": "586-979-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39242 DEQUINDRE RD",
            "address_2": "SUITE 105",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483101764",
            "telephone_number": "586-979-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMISHOFSKY",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301084290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "P47710003",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.