Individual provider Active NPI

Radha Mikkilineni, M.D.

  • Dermatopathology Physician
  • Garden City, NY
National Provider Identifier
1003842618
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
261852 Issued in NY
Practice address
54 New Hyde Park Rd
Garden City, NY 11530-3909
Phone
(516) 488-1313
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 261852 NY Primary

Addresses

Primary practice location

54 New Hyde Park Rd
Garden City, NY 11530-3909

Mailing address

911 Park Ave
Apt 1a
New York, NY 10075-0385
Phone (202) 723-2432

Other practice location 1

34 Bay St Ste 201
Sag Harbor, NY 11963-3104
Phone (631) 919-5087

Other practice location 2

1120 19th St NW
Suite 250
Washington, DC 20036-3605
Phone (202) 306-2472

Other practice location 3

700 Park Ave
New York, NY 10021-0104
Phone (212) 517-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20110818000204 NY Practitioner - Dermatology 2769448463 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Georgetown University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middletown Medical PCGroup PAC ID 2567464308, 177 clinicians
Scheiner Dermatology PLLCGroup PAC ID 0244501203, 3 clinicians
Belaray Dermatology PCGroup PAC ID 0941398671, 6 clinicians
Joseph Onorato MD PCGroup PAC ID 6800801655, 14 clinicians

Practice addresses (Care Compare)

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

156 E 79TH St
Apt 1a
New York, NY 10075-0570
Phone (212) 879-6614

2500 Nesconset Hwy
BLDG 20B
Stony Brook, NY 11790-2563
Phone (516) 822-7546

358 S Oyster Bay Rd
Hicksville, NY 11801-3508
Phone (516) 822-7546

54 New Hyde Park Rd
Garden City, NY 11530-3909
Phone (516) 488-1313

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
100
Improvement activities
40
Cost
89.16

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
68.46
Promoting interoperability
99
Improvement activities
40
Cost
77.61

Merit-based Incentive Payment System (MIPS)

Final score
93.82 of 100Reported as group
Quality
87.63
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions94
Removal or shaving of skin growth1-10
Skin biopsy51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
261852NYMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Jan 2, 2024 Accepting new patients
Mitchell a. Kline MD PC Dermatopathology CurrentSince Mar 1, 2020 Accepting new patients
Belaray Dermatology PC CurrentSince May 15, 2023 Accepting new patients
Comprehensive Dermatology, P.C. CurrentSince Feb 15, 2019 Accepting new patients
Robert L Bruckstein MD PC Current Accepting new patients
Scheiner Dermatology PLLC CurrentSince Sep 25, 2017 Accepting new patients
RM Dermatology, PLLC Dermatopathology CurrentSince Mar 1, 2026 Accepting new patients
Middletown Medical PC CurrentSince Jan 2, 2024 Accepting new patients
Rachel Shireen Golpanian MD P.C. Past Accepting new patients
Sadick Aesthetic Surgery and Dermatology PastSince Jun 1, 2012 Accepting new patients

Locations

358 S Oyster Bay Rd
Hicksville, NY 11801
Phone (516) 488-7546

111 Maltese Dr
Middletown, NY 10940

34 Bay St
Sag Harbor, NY 11963
Phone (212) 517-6555

34 Bay St
Ste 201
Sag Harbor, NY 11963
Phone (631) 919-5087

1122 Broadway
Woodmere, NY 11598
Phone (516) 295-3838

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: ram9090@direct.nyp.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/BEHDAD/Endpoint/BEHDAD

Organizations & group practices 11

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1003842618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 PARK AVE",
            "address_2": "APT 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750385",
            "telephone_number": "202-723-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 NEW HYDE PARK RD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303909",
            "telephone_number": "516-488-1313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Bay St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Sag Harbor",
            "state": "NY",
            "postal_code": "119633104",
            "country_code": "US",
            "telephone_number": "631-919-5087",
            "fax_number": "631-899-3478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 19th St NW",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200363605",
            "country_code": "US",
            "telephone_number": "202-306-2472",
            "fax_number": "202-723-2432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100210104",
            "country_code": "US",
            "telephone_number": "212-517-6555",
            "fax_number": "212-472-6796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKKILINENI",
        "first_name": "RADHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NY",
            "license": "261852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.