Individual provider Active NPI

Mallory Kathryn Joseph, MD

  • MOHS-Micrographic Surgery Physician
  • Grandville, MI
National Provider Identifier
1306337399
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
4301509122 Issued in MI
Practice address
4285 Parkway Place Dr SW
Grandville, MI 49418-2385
Phone
(616) 252-3376
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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 4301509122 MI
MOHS-Micrographic Surgery Physician 207ND0101X 4301509122 MI Primary

Addresses

Primary practice location

4285 Parkway Place Dr SW
Grandville, MI 49418-2385

Mailing address

4285 Parkway Place Dr SW
Grandville, MI 49418-2385
Phone (616) 252-3376

Other practice location 1

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-3376

Other practice location 2

4830 Becker Dr
Allendale, MI 49401-8616
Phone (616) 252-3376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230824002680 MI Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 8325393044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)Also: Dermatology
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

4830 Becker Dr
Allendale, MI 49401-8616
Phone (616) 252-3900

Hospital & facility affiliations

  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision19
Removal of skin lesions57
Removal of skin cancer122
Removal or shaving of skin growth1-10
Skin biopsy37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301509122MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Dermatology CurrentSince Jul 25, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince Jul 25, 2023 Accepting new patients
Metropolitan Hospital CurrentSince Sep 1, 2024 Accepting new patients
Metropolitan Hospital Past Accepting new patients
Metropolitan Hospital Past Accepting new patients
Metropolitan Hospital PastSince Sep 1, 2024 Accepting new patients

Locations

4830 Becker Dr
Allendale, MI 49401
Phone (616) 252-3376

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Spc 5314
Ann Arbor, MI 48109
Phone (734) 936-4054

4285 Parkway Place Dr SW
Grandville, MI 49418
Phone (616) 252-4300

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Interoperability endpoints

  • Direct secure messaging: mjoseph152343@direct.metrohealth.net

Organizations & group practices 6

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 2

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1306337399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4285 PARKWAY PLACE DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182385",
            "telephone_number": "616-252-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 PARKWAY PLACE DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182385",
            "telephone_number": "616-252-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Byron Center Ave SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199606",
            "country_code": "US",
            "telephone_number": "616-252-3376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4830 Becker Dr",
            "address_purpose": "LOCATION",
            "city": "Allendale",
            "state": "MI",
            "postal_code": "494018616",
            "country_code": "US",
            "telephone_number": "616-252-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "MALLORY",
        "middle_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301509122",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MI",
            "license": "4301509122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.