Enrico John Versace, M.D.
Individual provider Active NPI Internal Medicine Physician · Del Norte, CO
NPI 1699740480 · NPPES record last updated Mar 27, 2017
Key facts
- NPI
- 1699740480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 0053518 (CO)
- Practice address
- 310 County Road 14
Rio Grande Hospital
Del Norte, CO 81132-8719 - Phone
- (719) 657-4102
- Fax
- (719) 657-4106
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Apogee Medical Group North Carolina
Practice addresses (Care Compare)
317 Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 577-2345
Hospital & facility affiliations
- Onslow Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.67 of 100
- Quality
- 88.12
- Improvement activities
- 40
- Cost
- 77.69
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180924002862 | NC | Practitioner - Internal Medicine |
3375455520 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0053518 | CO | MD | Internal Medicine Physician |
| 60167506 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Onslow Memorial Hospital Inc | Current |
Accepting new patients | |
| Apogee Medical Group North Carolina | Hospitalist | Current |
Accepting new patients |
| Cogent Healthcare of North Carolina, PC | Internal Medicine | Current |
Accepting new patients |
| Hospitalist Medicine Physicians of North Carolina PLLC | Internal Medicine | Current |
Accepting new patients |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Utah Regional Hospitalists LLC | Hospitalist | Past | Accepting new patients |
Locations
1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000
317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240
615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 11019 | MT | |
| Internal Medicine Physician | 207R00000X | 0053518 | CO | Yes |
| Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 2083P0011X | 60167506 | WA | |
| Internal Medicine Physician | 207R00000X | 60167506 | WA |
Addresses
Primary practice location
310 County Road 14
Rio Grande Hospital
Del Norte, CO 81132-8719
Mailing address
310 County Road 14
Rio Grande Hospital
Del Norte, CO 81132-8719
Phone (719) 657-4102
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53518 | Other | CO | CO LICENSE |
| 47105348 | Medicaid | CO |
Other providers in Del Norte, CO
- Valley Citizens' Foundation for Health Care Inc
- Valley Citizens' Foundation for Health Care Inc
- Valley Citizens' Foundation for Health Care Inc
- Valley Citizens' Foundation for Health Care Inc
- Valley Citizens' Foundation for Health Care, Inc
- Anna Christine Walker
- James Ely Walker
- Kelsey Jo Hurley Walker
- Tiffany Jo Ward
- Kimberly A Woodke
All providers in Del Norte, CO · Internal Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.