NPIMap

Individual provider Active NPI

Michael J O'Donnell, M.D.

  • MOHS-Micrographic Surgery Physician
  • Scranton, PA
National Provider Identifier
1215930722
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD041957E Issued in PA
Practice address
327 N Washington Ave
Ste 200
Scranton, PA 18503-1535
Phone
(570) 961-5522
Fax
(570) 207-5579
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD041957E PA
MOHS-Micrographic Surgery Physician 207ND0101X MD041957E PA Primary

Addresses

Primary practice location

327 N Washington Ave
Ste 200
Scranton, PA 18503-1535

Mailing address

327 N Washington Ave
Ste 200
Scranton, PA 18503-1535
Phone (570) 961-5522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050513000215 PA Practitioner - Dermatology 1658312269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Jefferson Medical College of Thomas Jefferson University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lackawanna Valley Dermatology Associates LimitedGroup PAC ID 2668459066, 18 clinicians

Practice addresses (Care Compare)

327 N Washington Ave
Scranton, PA 18503-1535
Phone (570) 961-5522

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.11 of 100Reported as group
Quality
96.44
Promoting interoperability
100
Improvement activities
40
Cost
67.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision217
Removal of tissue1-10
Removal of skin lesions542
Removal of skin cancer1153
Removal of nail tissue1-10
Removal or shaving of skin growth25
Skin biopsy178

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD041957EPAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lackawanna Valley Dermatology Associates Limited Dermatology CurrentSince Apr 13, 1998 Accepting new patients

Locations

440 Pierce St
Kingston, PA 18704
Phone (570) 287-1122

327 N Washington Ave
Ste 200
Scranton, PA 18503
Phone (570) 961-5522

327 N Washington Ave
Scranton, PA 18503
Phone (570) 342-4246

Interoperability endpoints

  • Direct secure messaging: modonnell@lackaderm.medentdirect.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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1215930722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 N WASHINGTON AVE",
            "address_2": "STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031535",
            "telephone_number": "570-961-5522",
            "fax_number": "570-207-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 N WASHINGTON AVE",
            "address_2": "STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031535",
            "telephone_number": "570-961-5522",
            "fax_number": "570-207-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD041957E",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "PA",
            "license": "MD041957E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.