Active NPI
Nicholas Kian Mollanazar, MD, MBA
- Dermatology Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD467873
- Practice address
- 800 Spruce Street
10TH Floor
Philadelphia, PA 19107-5701 - Phone
- (941) 718-8997
- NPI assigned
- Mar 31, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD467873 | PA | Primary |
Addresses
Primary practice location
800 Spruce Street
10TH Floor
Philadelphia, PA 19107-5701
Mailing address
3400 Civic Center Blvd
1St Floor, Derm
Philadelphia, PA 19104-5127
Phone (941) 718-8997
Other practice location 1
3400 Civic Center Boulevard
South Pavilion 1st floor
Philadelphia, PA 19104
Phone (215) 662-7366
Other practice location 2
3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3376
Other practice location 3
3400 Spruce St
2 Maloney Building
Philadelphia, PA 19104
Phone (215) 662-7366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Temple University School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3400 Civic Ctr Blvd
Suite 1 330S
Philadelphia, PA 19104-5132
Phone (215) 662-2737
Hospital & facility affiliations
- Hospital of Univ of Pennsylvania
- Pennsylvania Hospital
- Penn Presbyterian Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.91 of 100
- Quality
- 73.58
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.13
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 12 |
| Removal of skin lesions | 595 |
| Removal of skin cancer | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 36 |
| Skin biopsy | 375 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD467873 | PA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Penn-Medical Group | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| University of Penn - Medical Group | Past | Accepting new patients |
Locations
3400 Civic Center Blvd
Ste 1-330S
Philadelphia, PA 19104
Phone (215) 360-0909
3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669
501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046
3400 Civic Center Blvd
Fl 1
Philadelphia, PA 19104
Phone (215) 615-5864
800 Spruce St
Fl 10
Philadelphia, PA 19107
Phone 2157327600102
235 S 8th St
Philadelphia, PA 19106
Phone (215) 543-2770
3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428
1000 Floral Vale Blvd
Yardley, PA 19067
Phone (215) 752-4020
Networks
- devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
- devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
- devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
- OH PPO
- devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
Organizations & group practices 4
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.
-
- Gynecologic Oncology Physician
- Philadelphia, PA
- NPI 1235527342
-
- Neurological Surgery Physician
- Philadelphia, PA
- NPI 1790173805
-
- Surgical Oncology Physician
- Philadelphia, PA
- NPI 1871981985
-
- Cardiovascular Disease Physician
- Philadelphia, PA
- NPI 1093725145
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1245207521
-
- General Acute Care Hospital
- Phila, PA
- NPI 1063489342
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1851370910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1003201617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD",
"address_2": "1ST FLOOR, DERM",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045127",
"telephone_number": "941-718-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 SPRUCE STREET",
"address_2": "10TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075701",
"telephone_number": "941-718-8997"
}
],
"practiceLocations": [
{
"address_1": "3400 Civic Center Boulevard",
"address_2": "South Pavilion 1st floor",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "19104",
"country_code": "US",
"telephone_number": "215-662-7366",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3401 N Broad St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191405103",
"country_code": "US",
"telephone_number": "215-707-3376",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3400 Spruce St",
"address_2": "2 Maloney Building",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "19104",
"country_code": "US",
"telephone_number": "215-662-7366",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOLLANAZAR",
"first_name": "NICHOLAS",
"middle_name": "KIAN",
"name_prefix": "Dr.",
"credential": "MD, MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-31",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "PA",
"license": "MD467873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.