Individual provider Active NPI

Victor Demarco, MD

  • Diagnostic Radiology Physician
  • Chardon, OH
National Provider Identifier
1790778751
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35029419 Issued in OH
Practice address
13207 Ravenna Rd
Chardon, OH 44024-7032
Phone
(440) 285-6000
Fax
(216) 844-5922
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35029419 OH Primary

Addresses

Primary practice location

13207 Ravenna Rd
Chardon, OH 44024-7032

Mailing address

24701 Euclid Ave
Third Floor
Euclid, OH 44117-1714
Phone (440) 285-6000

Other identifiers 3

IdentifierTypeStateIssuer
P00412445OtherOHRAILROAD MEDICARE
0304914OtherOHBCMH
0326696MedicaidOH

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
35029419OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Hill & Thomas Co. Diagnostic Radiology Past Accepting new patients
Regional Diagnostics LLC Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients
Regional Diagnostics LLC Past Accepting new patients
University Primary Care Practices Inc Diagnostic Radiology Past Accepting new patients
DRS. Hill & Thomas Co. Past Accepting new patients
University Imaging Inc Diagnostic Radiology Past Accepting new patients

Organizations & group practices 7

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1790778751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "THIRD FLOOR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "440-285-6000",
            "fax_number": "216-844-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13207 RAVENNA RD",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440247032",
            "telephone_number": "440-285-6000",
            "fax_number": "216-844-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "VICTOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35029419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00412445",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "0304914",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0326696",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.