Jorge Luis Crespo, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

8345 Issued in NH

Practice address

745A Route 63
Chesterfield, NH 03443-3604

Phone

(800) 303-8984

Fax

(603) 363-4450

NPI assigned

Jun 6, 2006

Last updated

Nov 1, 2007By the provider in NPPES

Sex

Male

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 4

Medicare fee-for-service enrollment

Enrolled in NH

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 Michigan Medical School, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of Chesterfield LLCGroup PAC ID 4587825252, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Integrated Dermatology of Chesterfield LLC

  • Dermatology Physician
  • Chesterfield, NH
  • NPI 1265703235
  Medicare reassignment Care Compare group NPD
• On Site Dermatology LLC

  • Dermatology Physician
  • Boca Raton, FL
  • NPI 1215978713

  NH

  Medicare reassignment NPD
• Dermatology Associates of the Northeast, PC

  • Dermatology Physician
  • Chesterfield, NH
  • NPI 1558314542
  NPD (past) Authorized official
• Urology Assocs of Monad

  • Urology Physician
  • Keene, NH
  • NPI 1487733598
  NPD (past)
• Eureka Diagnostic Imaging PC

  • Diagnostic Radiology Physician
  • Springfield, VT
  • NPI 1578504346
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1881633568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013020910",
            "telephone_number": "413-772-8500",
            "fax_number": "413-772-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745A ROUTE 63",
            "city": "CHESTERFIELD",
            "state": "NH",
            "postal_code": "034433604",
            "telephone_number": "800-303-8984",
            "fax_number": "603-363-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESPO",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NH",
            "license": "8345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NH",
            "identifier": "0104793Y0VT01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS VT",
            "identifier": "8233",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003577",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2029",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Davey Ahava, PA
• Dermatology Associates of the Northeast, PC
• Integrated Dermatology of Chesterfield LLC

• Dermatology Physician in Chesterfield, NH
• Providers in Chesterfield, NH by specialty
• Dermatology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.