Grace Dolores Bandow, M.D.
Individual provider Active NPI Dermatology Physician · Shelton, CT
NPI 1871709147 · NPPES record last updated Apr 20, 2023
Key facts
- NPI
- 1871709147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 47948 (CT)
- Practice address
- 4 Corporate Dr
Shelton, CT 06484-6211 - Phone
- (203) 538-5682
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- University of Wisconsin School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Connecticut Skinhealth LLP
Practice addresses (Care Compare)
4 Corporate Dr
Shelton, CT 06484-6211
Phone (203) 538-5682
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 390 |
| Skin biopsy | 204 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- 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 |
|---|---|---|---|---|
| I20180503001789 | CT | Practitioner - Dermatology | 6305901661 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47948 | CT | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Schweiger Dermatology PLLC | Dermatology | Current |
Accepting new patients |
| Connecticut Skinhealth LLP | Current |
Accepting new patients | |
| The Connecticut Dermatology Group PLLC | Dermatology | Current |
Accepting new patients |
Locations
761 Main Ave
Ste 102
Norwalk, CT 06851
Phone (203) 810-4151
4 Corporate Dr
Shelton, CT 06484
Phone (203) 538-5682
4 Corporate Dr
Ste 386
Shelton, CT 06484
Phone (203) 538-5682
1250 Summer St
Ste 201
Stamford, CT 06905
Phone (203) 975-1112
Interoperability endpoints
- gbandow@ctsh.emadirect.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology Physician | 207ND0900X | 47948 | CT | |
| Dermatology Physician | 207N00000X | 47948 | CT | Yes |
Addresses
Primary practice location
4 Corporate Dr
Shelton, CT 06484-6211
Mailing address
4 Corporate Dr
Shelton, CT 06484-6211
Phone (203) 538-5682
Other providers in Shelton, CT
- Brittany Balducci
- Beth A Balko
- Jillian Ingrid Ball
- Dammy Bamisile
- Foluke R Bamisile
- Daisy H Bang
- Joseph William Barbar
- Vanessa L Barber
- Elaine Barclay
- Dorothy Ann Barr-Reseska
All providers in Shelton, CT · Dermatology Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2023. 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.