Michael Ray Proctor, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

3378 Issued in AZ

Practice address

3015 Highway 95
#110
Bullhead City, AZ 86442

Phone

(928) 758-8885

Fax

(928) 758-2424

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

No

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 AZ

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

Dermatology

Education

College of Osteo Med of the Pacific at Pomona, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Desert Dermatology and Surgery PCGroup PAC ID 6305732512, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.61 of 100Reported as individual

Quality

76.11

Promoting interoperability

100

Improvement activities

40

Cost

65.91

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Arizona Desert Dermatology and Surgery PC

  • Dermatology Physician
  • Kingman, AZ
  • NPI 1386702546
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1265501779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 95",
            "address_2": "#110",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-758-8885",
            "fax_number": "928-758-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 95",
            "address_2": "#110",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-758-8885",
            "fax_number": "928-758-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "3378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prescott Healthcare Solutions LLC
• Derek Patrick Price, D.C.
• Tyler Primavera, D.O.
• Pro Imagining Az LLC (Pro Imagining AZ)
• Christopher Alan Proctor, CNS, CRNFA
• Ryan Mark Proctor, D.O.
• Promptcare PC
• Pulmonology Group LLC
• Terry M Puryear
• Zhijia Jack Qiu, D.C.

• Dermatology Physician in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.