Reason Wilken, MD
Individual provider Active NPI MOHS-Micrographic Surgery Physician · North New Hyde Park, NY
NPI 1174814735 · NPPES record last updated Sep 28, 2020
Key facts
- NPI
- 1174814735
- Entity type
- Individual (NPI type 1)
- Primary specialty
- MOHS-Micrographic Surgery Physician 207ND0101X
- License
- 298778-1 (NY)
- Practice address
- 1991 Marcus Ave Ste 300
North New Hyde Park, NY 11042-2058 - Phone
- (516) 321-8551
- NPI assigned
- Apr 29, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Shore-Lij Medical PC
Practice addresses (Care Compare)
1991 Marcus Ave
Suite 300
New Hyde Park, NY 11042-2057
Phone (516) 719-3376
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 78 |
| Removal of skin lesions | 1-10 |
| Removal of skin cancer | 447 |
| Skin biopsy | 18 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, NY
- 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 |
|---|---|---|---|---|
| I20150204000000 | CA | Practitioner - Dermatology | 8123343613 | Reassigns benefits to 1 organization |
| I20200827001676 | NY | Practitioner - Dermatology | 8123343613 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 298778-1 | NY | MD | MOHS-Micrographic Surgery Physician |
Practice roles (5 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the Univ of Ca | Current |
Accepting new patients | |
| Regents of the Univ of Ca | Current |
Accepting new patients | |
| North Shore-Lij Medical PC | Current |
Accepting new patients | |
| North Shore - Lij Medical PC | Current |
Accepting new patients | |
| Regents of the Univ of Ca | Current | Accepting new patients |
Locations
3301 C St
Ste 1400
Sacramento, CA 95816
Phone (916) 734-6111
4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700
4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
1991 Marcus Ave
Ste 300
North New Hyde Park, NY 11042
Phone (516) 321-8509
300 Community Dr
Plandome, NY 11030
972 Brush Hollow Rd
Westbury, NY 11590
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
Interoperability endpoints
- reasonwilken@nslijmedgr.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | 298778-1 | NY | Yes |
Addresses
Primary practice location
1991 Marcus Ave Ste 300
North New Hyde Park, NY 11042-2058
Mailing address
Northwell Health Dermatology
1991 Marcus Avenue Suite 300
North New Hyde Park, NY 10042-3300
Phone (516) 719-3376
Other providers in North New Hyde Park, NY
All providers in North New Hyde Park, NY · MOHS-Micrographic Surgery Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 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.