Individual provider Active NPI

Mary Kate Rohan, M.D.

  • Specialist
  • Anaheim, CA
National Provider Identifier
1235211194
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G73700 Issued in CA
Practice address
1211 W la Palma Ave Ste 407
Anaheim, CA 92801-2806
Phone
(714) 284-4912
Fax
(714) 284-4819
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G73700 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave Ste 407
Anaheim, CA 92801-2806

Mailing address

1211 W la Palma Ave Ste 407
Anaheim, CA 92801-2806
Phone (714) 284-4912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090414000763 CA Practitioner - Dermatology 3476600107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, Irvine, California College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1211 W la Palma Ave
Suite 407
Anaheim, CA 92801-2806
Phone (714) 284-4912

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1077
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G73700CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Kate Rohan M.D., Inc CurrentSince Jan 1, 2008 Accepting new patients
Brodsky Dermatology and Skin Cancer, PC PastSince Dec 14, 2025 Accepting new patients

Locations

1211 W La Palma Ave
Ste 407
Anaheim, CA 92801
Phone (714) 284-4912

Organizations & group practices 2

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235211194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 407",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012806",
            "telephone_number": "714-284-4912",
            "fax_number": "714-284-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 407",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012806",
            "telephone_number": "714-284-4912",
            "fax_number": "714-284-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHAN",
        "first_name": "MARY",
        "middle_name": "KATE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G73700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.