Individual provider Active NPI

Michael J Mulvaney, M.D.

  • MOHS-Micrographic Surgery Physician
  • Albany, NY
National Provider Identifier
1063405025
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
182393-1 Issued in NY
Practice address
264 Washington Avenue Ext Ste 201
Albany, NY 12203
Phone
(518) 452-1928
Fax
(518) 362-1348
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X 182393 NY
MOHS-Micrographic Surgery Physician 207ND0101X 182393-1 NY Primary

Addresses

Primary practice location

264 Washington Avenue Ext Ste 201
Albany, NY 12203

Mailing address

264 Washington Avenue Ext Ste 201
Albany, NY 12203-6352
Phone (518) 452-1928

Other identifiers 1

IdentifierTypeStateIssuer
1823931OtherNYNYLICENSE

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
I20040629000633 NY Practitioner - Dermatology 0941286629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Albany Medical College of Union University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Specialists of the Capital Region, PLLCGroup PAC ID 5597741371, 12 clinicians

Practice addresses (Care Compare)

264 Washington Ave Ext
Suite 201
Albany, NY 12203-6352
Phone (518) 452-1928

Merit-based Incentive Payment System (MIPS)

Final score
92.03 of 100Reported as group
Quality
97.72
Improvement activities
40
Cost
76.47

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision56
Removal of tissue1-10
Removal of skin lesions60
Removal of skin cancer620
Removal of nail tissue1-10
Skin biopsy124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182393NYMDMOHS-Micrographic Surgery Physician
182393-1NYMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Specialists of the Capital Region, PLLC Single Specialty CurrentSince Jul 2, 2004 Accepting new patients

Locations

264 Washington Avenue Ext
Ste 201
Albany, NY 12203
Phone (518) 452-1928

Organizations & group practices 1

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1063405025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 WASHINGTON AVENUE EXT STE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122036352",
            "telephone_number": "518-452-1928",
            "fax_number": "518-362-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 WASHINGTON AVENUE EXT STE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12203",
            "telephone_number": "518-452-1928",
            "fax_number": "518-362-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULVANEY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "182393",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "182393-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYLICENSE",
            "identifier": "1823931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.