Jamie Surovik, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

48670 Issued in CO

Practice address

12645 E Euclid Dr
Centennial, CO 80111-6437

Phone

(303) 493-1910

Fax

(303) 493-1915

NPI assigned

Apr 21, 2010

Last updated

Dec 9, 2020By the provider in NPPES

Sex

Female

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 2

Electronic endpoints 1

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

Dermatology

Education

University of Texas Medical School at Houston, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology Skin Cancer and Laser Surgery Center P.C.Group PAC ID 6709775133, 16 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.94 of 100Reported as group

Quality

100

Promoting interoperability

96

Improvement activities

40

Cost

73.13

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 Skin Cancer & Laser Surgery Center P.C.

  • Dermatology Physician
  • Aurora, CO
  • NPI 1134170012
  Medicare reassignment Care Compare group NPD
• Advanced Dermatology Skin Cancer & Laser Surgery Center P.C.

  • Dermatology Physician
  • Castle Rock, CO
  • NPI 1811590433
  NPD

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1699092221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12645 E EUCLID DR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116437",
            "telephone_number": "303-493-1910",
            "fax_number": "303-493-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12645 E EUCLID DR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116437",
            "telephone_number": "303-493-1910",
            "fax_number": "303-493-1915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30960 Stagecoach Blvd Ste W140",
            "address_purpose": "LOCATION",
            "city": "Evergreen",
            "state": "CO",
            "postal_code": "804397897",
            "country_code": "US",
            "telephone_number": "303-670-7065",
            "fax_number": "303-674-6055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 Summit Blvd",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "CO",
            "postal_code": "804435881",
            "country_code": "US",
            "telephone_number": "970-668-9650",
            "fax_number": "970-668-9654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUROVIK",
        "first_name": "JAMIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "48670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68171315",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "48670",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgsurovik@advaderm.emadirect.md",
            "affiliation": "N",
            "address_1": "12645 E Euclid Dr",
            "city": "Centennial",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801116437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashlynn Super
• Supplemental Health Care
• Supplemental Healthcare
• Surgone, PC
• Anuj Suri, DDS
• Katherine Jane Swan, OTD, OTR/L
• Donna V Swanson, MA
• Jeanne Swanson, RN
• Sarah Beth Swanson, MD
• Thomas G Swanson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.