Individual provider Active NPI

Michael Keene Muhlert, M.D.

  • Vascular & Interventional Radiology Physician
  • Memphis, TN
National Provider Identifier
1063630093
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
42710 Issued in TN
Practice address
5959 Park Ave
MPRG
Memphis, TN 38119-5200
Phone
(901) 765-3213
Fax
(901) 765-1727
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 19865 MS
Diagnostic Radiology Physician 2085R0202X 042710 TN
Vascular & Interventional Radiology Physician 2085R0204X E-5336 AR
Vascular & Interventional Radiology Physician 2085R0204X 19865 MS
Diagnostic Radiology Physician 2085R0202X E-5336 AR
Vascular & Interventional Radiology Physician 2085R0204X 42710 TN Primary
Vascular & Interventional Radiology Physician 2085R0204X 32039 SC

Addresses

Primary practice location

5959 Park Ave
MPRG
Memphis, TN 38119-5200

Mailing address

5959 Park Ave
Memphis Physicians Radiology Practice Group
Memphis, TN 38119-5198
Phone (901) 765-3213

Other identifiers 1

IdentifierTypeStateIssuer
12112969OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100708000850 AR Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2769513761 Reassigns benefits to 1 organization
I20100708000967 TN Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2769513761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Texas Medical School at Houston, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memphis Physicians Radiological Group PCGroup PAC ID 9830123736, 79 clinicians

Practice addresses (Care Compare)

5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-2191

900 W Kingshighway
Paragould, AR 72450-5942
Phone (870) 239-7101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32039SCMDCommunity Health Registered Nurse
E-5336ARMDDiagnostic Radiology Physician
42710TNMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Memphis Pet Imaging, LLC Diagnostic Radiology CurrentSince Aug 25, 2012 Accepting new patients
Saint Francis Physician Network, LLC Past Accepting new patients
MV Clinic PLLC PastSince Dec 3, 2023 Accepting new patients

Locations

2527 Cranberry Hwy
Wareham, MA 02571
Phone (508) 295-5556

10 Little Brook Rd
West Wareham, MA 02576

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

6005 Park Ave
Ste 101B
Memphis, TN 38119
Phone (901) 685-3114

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1063630093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 PARK AVE",
            "address_2": "MEMPHIS PHYSICIANS RADIOLOGY PRACTICE GROUP",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195198",
            "telephone_number": "901-765-3213",
            "fax_number": "901-765-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 PARK AVE",
            "address_2": "MPRG",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195200",
            "telephone_number": "901-765-3213",
            "fax_number": "901-765-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHLERT",
        "first_name": "MICHAEL",
        "middle_name": "KEENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "19865",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "042710",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AR",
            "license": "E-5336",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MS",
            "license": "19865",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-5336",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "42710",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "SC",
            "license": "32039",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12112969",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.