Individual provider Active NPI

Michael Gregory Foss

  • Dermatology Physician
  • Bradenton, FL
National Provider Identifier
1285193193
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
OS17790 Issued in FL
Practice address
2101 61St St W
Bradenton, FL 34209-5528
Phone
(941) 677-9070
Fax
(941) 296-8501
NPI assigned
Mar 19, 2019
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X OS17790 FL Primary

Addresses

Primary practice location

2101 61St St W
Bradenton, FL 34209-5528

Mailing address

4411 Bee Ridge Rd # 309
Sarasota, FL 34233-2514
Phone (941) 926-6553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230719001216 FL Practitioner - Dermatology 9537529771 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminary Dermatology PAGroup PAC ID 8628301835, 9 clinicians

Practice addresses (Care Compare)

2101 61St St W
Bradenton, FL 34209-5528
Phone (941) 926-6553

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision180
Removal of skin lesions1214
Removal of skin cancer342
Removal or shaving of skin growth1-10
Skin biopsy818

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Luminary Dermatology of Miami, LLC CurrentSince Jan 3, 2025 Accepting new patients
MCR Health, Inc. CurrentSince Jun 23, 2023 Accepting new patients
MCR Health, Inc. CurrentSince Jun 23, 2023 Accepting new patients
Luminary Dermatology, PA Dermatology CurrentSince Sep 1, 2023 Accepting new patients

Locations

101 Riverfront Blvd
Ste 710
Bradenton, FL 34205

2101 61st St W
Bradenton, FL 34209
Phone (941) 761-4448

300 Riverside Dr E
Ste 2010
Bradenton, FL 34208
Phone (941) 405-1170

6015 Pointe West Blvd
Bradenton, FL 34209
Phone (941) 782-0101

925 NE 30th Ter
Ste 308
Homestead, FL 33033
Phone (305) 245-2768

544 Bay Isles Rd
Longboat Key, FL 34228
Phone (941) 225-2258

8740 SW 88th St
Ste 101
Miami, FL 33176
Phone (305) 274-5574

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

4411 Bee Ridge Rd
Sarasota, FL 34233
Phone (941) 342-3201

Interoperability endpoints

  • Direct secure messaging: michael.foss.1@11352.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1285193193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 BEE RIDGE RD # 309",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332514",
            "telephone_number": "941-926-6553",
            "fax_number": "941-296-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 61ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095528",
            "telephone_number": "941-677-9070",
            "fax_number": "941-296-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSS",
        "first_name": "MICHAEL",
        "middle_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS17790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.