Individual provider Active NPI

Mychael Luu, M.D.

  • Dermatology Physician
  • San Jose, CA
National Provider Identifier
1093718546
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A61816 Issued in CA
Practice address
2050 Clarmar Way
San Jose, CA 95128-1704
Phone
(408) 294-7551
Fax
(408) 294-7201
NPI assigned
May 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A61816 CA Primary

Addresses

Primary practice location

2050 Clarmar Way
San Jose, CA 95128-1704

Mailing address

2050 Clarmar Way
San Jose, CA 95128-1704
Phone (408) 294-7551

Other identifiers 1

IdentifierTypeStateIssuer
00A618160MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070323000497 CA Practitioner - Dermatology 2365546777 Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2050 Clarmar Way
San Jose, CA 95128-1704
Phone (408) 294-7551

Merit-based Incentive Payment System (MIPS)

Final score
97.6 of 100Reported as individual
Quality
86.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision44
Removal of skin lesions1158
Removal of skin cancer58
Removal of nail tissue1-10
Removal or shaving of skin growth13
Skin biopsy204

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A61816CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Past Accepting new patients
O'Connor Hospital Past Accepting new patients

Organizations & group practices 2

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": "1117238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1093718546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 CLARMAR WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281704",
            "telephone_number": "408-294-7551",
            "fax_number": "408-294-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 CLARMAR WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281704",
            "telephone_number": "408-294-7551",
            "fax_number": "408-294-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "MYCHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-28",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A61816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A618160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.