Michigan City Dermatology and Vein Clinic LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MICHIGAN CITY DERMATOLOGY AND VEIN CLINIC LLC

Practice address

10282 W 400 N
Michigan City, IN 46360-9470

Phone

(773) 351-2862

Fax

(773) 358-2767

NPI assigned

Jun 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Vassilios Athanasios Dimitropoulos, MDNPI 1194838045

Title

President

Phone

(773) 351-2862

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vassilios A. Dimitropoulos, M.D.

  • Dermatology Physician
  • Michigan City, IN
  • NPI 1194838045
  Medicare reassignment Care Compare group NPD Authorized official
• Melissa McIver, NP

  • Nurse Practitioner
  • Benton Harbor, MI
  • NPI 1518433291

  IN

  Medicare reassignment Care Compare group NPD
• Cailey Rooker, PA-C

  • Dermatology Physician
  • Saint Joseph, MI
  • NPI 1609699123

  IN

  Medicare reassignment
• Stamatis Dimitropoulos, M.D.

  • Internal Medicine Physician
  • Darien, IL
  • NPI 1417122599
  NPD
• Valerie Laniosz, M.D., PHD

  • Dermatology Physician
  • Darien, IL
  • NPI 1699064824
  NPD

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1962027581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 S PARK AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605214645",
            "telephone_number": "773-351-2862",
            "fax_number": "773-358-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10282 W 400 N",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609470",
            "telephone_number": "773-351-2862",
            "fax_number": "773-358-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN CITY DERMATOLOGY AND VEIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "DIMITROPOULOS",
        "authorized_official_first_name": "VASSILIOS",
        "authorized_official_middle_name": "ATHANASIOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-351-2862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michiana Cancer Treatment Center
• Michiana Resources, Inc.
• Michiana Resources, Inc.
• Michigan City Area Schools
• Michigan City Dental, P.C.
• Michigan City Family Dentistry
• Michigan City Foot
• Michigan City House of Hope
• Michigan City Radiologists, Inc
• Michigan City RCF LP

• Dermatology Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Dermatology Physician in Indiana

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