Michael Brian Zaycosky, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS015047 Issued in PA

Practice address

7176 W Ridge Rd
Fairview, PA 16415-2027

Phone

(814) 413-7997

Fax

(814) 413-7998

NPI assigned

Aug 5, 2008

Last updated

Jun 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

Lake Erie College of Osteopathic Medicine, Erie, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Live Oak Dermatology PCGroup PAC ID 2769830322, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drzaycosky@liveoakderm.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Live Oak Dermatology PC

  • MOHS-Micrographic Surgery Physician
  • Fairview, PA
  • NPI 1609654466

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1174789507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7176 W RIDGE RD",
            "city": "FAIRVIEW",
            "state": "PA",
            "postal_code": "164152027",
            "telephone_number": "814-413-7997",
            "fax_number": "814-413-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7176 W RIDGE RD",
            "city": "FAIRVIEW",
            "state": "PA",
            "postal_code": "164152027",
            "telephone_number": "814-413-7997",
            "fax_number": "814-413-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAYCOSKY",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OS015047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Walmer, LAT, ATC, PTA
• Mary Kathryn Washok, COTA/L
• Kathleen Wernicki
• Melissa Wright, FNP-BC
• Rochelle R Youkers, LCSW

• Dermatology Physician in Fairview, PA
• Providers in Fairview, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.