Individual provider Active NPI

Ronald E Michalak, MD

  • Orthopaedic Surgery Physician
  • Peterborough, NH
National Provider Identifier
1093824591
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
11969 Issued in NH
Practice address
458 Old Street Rd
Suite 200
Peterborough, NH 03458-1265
Phone
(603) 924-2144
Fax
(603) 924-3993
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 11969 NH
Orthopaedic Surgery Physician 207X00000X 11969 NH Primary

Addresses

Primary practice location

458 Old Street Rd
Suite 200
Peterborough, NH 03458-1265

Mailing address

458 Old Street Rd
Suite 200
Peterborough, NH 03458-1265
Phone (603) 924-2144

Other identifiers 3

IdentifierTypeStateIssuer
01Y005045NH02OtherNHANTHEM BCBS MCH
30203621MedicaidNH
01Y005045NH03OtherNHANTHEM BCBS MOA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20050728000362 NH Practitioner - Orthopedic Surgery 9133157415

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11969NHMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monadnock Community Hospital Current Accepting new patients

Locations

452 Old Street Rd
Peterborough, NH 03458
Phone (603) 924-4699

Interoperability endpoints

  • Direct secure messaging: ronald.michalak@mhp.eclinicaldirectplus.com

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1093824591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 OLD STREET RD",
            "address_2": "SUITE 200",
            "city": "PETERBOROUGH",
            "state": "NH",
            "postal_code": "034581265",
            "telephone_number": "603-924-2144",
            "fax_number": "603-924-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 OLD STREET RD",
            "address_2": "SUITE 200",
            "city": "PETERBOROUGH",
            "state": "NH",
            "postal_code": "034581265",
            "telephone_number": "603-924-2144",
            "fax_number": "603-924-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALAK",
        "first_name": "RONALD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NH",
            "license": "11969",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NH",
            "license": "11969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS  MCH",
            "identifier": "01Y005045NH02",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203621",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS  MOA",
            "identifier": "01Y005045NH03",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peterborough, NH

Sources for this page

Verify at the official NPI Registry.