Michael Cosulich, MD
Individual provider Active NPI Dermatology Physician · Wall, NJ
NPI 1124439757 · NPPES record last updated Aug 28, 2020
Key facts
- NPI
- 1124439757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 25MA09959400 (NJ)
- Practice address
- 3350 Highway 138 West
Building 2, Suite 122
Wall, NJ 07719 - Phone
- (732) 280-1200
- Fax
- (732) 280-1207
- NPI assigned
- May 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Georgetown University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cosulich Dermatology LLC
Practice addresses (Care Compare)
3350 Hwy 138 W
BLDG 2 Suite 122
Wall, NJ 07719-9694
Phone (732) 280-1200
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.2 of 100
- Quality
- 100
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 83.99
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 140 |
| Removal of skin lesions | 2590 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1138 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170719002232 | NJ | Practitioner - Dermatology | 2860716735 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09959400 | NJ | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cosulich Dermatology LLC | Multi-Specialty | Current |
Accepting new patients |
| Cosulich Dermatology 2 LLC | Dermatology | Current |
Accepting new patients |
Locations
1004 Commons Way
#G
Toms River, NJ 08755
Phone (732) 349-6868
3350 State Route 138
Ste 122
Wall Township, NJ 07719
Phone (732) 280-1200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | 24922 | MS | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dermatology Physician | 207N00000X | 25MA09959400 | NJ | Yes |
Addresses
Primary practice location
3350 Highway 138 West
Building 2, Suite 122
Wall, NJ 07719
Mailing address
3350 Highway 138 West
Building 2, Suite 122
Wall, NJ 07719
Phone (732) 280-1200
Other providers in Wall, NJ
- Tiffany Cherry
- Shobha A Chottera
- Christina Marie Cognetti
- Domenico Colletti Jr.
- Complete Care by BDM, LLC
- Crean Counseling LLC
- Crystal Clear Diagnostics Services Inc
- Susan Jane Curley
- Brian Daniel D'Allura
- Stephanie D'Allura
All providers in Wall, NJ · Dermatology Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.