Organization Active NPI

Muhlbauer Dermatopathology PC

  • Dermatopathology Physician
  • Pittsford, NY
National Provider Identifier
1346258241
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
Legal business name
MUHLBAUER DERMATOPATHOLOGY PC
Practice address
61 Monroe Avenue
Suite B
Pittsford, NY 14534
Phone
(585) 586-5166
Fax
(585) 586-1370
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Jan E Muhlbauer, MDNPI 1639407687
Title
Lab Director
Phone
(585) 586-5166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0900X NY Primary

Addresses

Primary practice location

61 Monroe Avenue
Suite B
Pittsford, NY 14534

Mailing address

PO Box 23930
Rochester, NY 14692
Phone (585) 586-5166

Other identifiers 3

IdentifierTypeStateIssuer
CL017OtherNYPREFERRED CARE
00823996MedicaidNY
PO14939759OtherNYBLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091216000426 NY Part B Supplier - Independent Clinical Laboratory 8426198870 Practice locations: Pittsford, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0172276Muhlbauer Dermatopathology PC61 Monroe Ave, Pittsford, NY 14534ComplianceMar 26, 2027

National Provider Directory

National Provider Directory

Locations

61 Monroe Ave
Ste D
Pittsford, NY 14534
Phone (585) 586-5632

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1346258241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23930",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14692",
            "telephone_number": "585-586-5166",
            "fax_number": "585-586-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MONROE AVENUE",
            "address_2": "SUITE B",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "14534",
            "telephone_number": "585-586-5166",
            "fax_number": "585-586-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUHLBAUER DERMATOPATHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "MUHLBAUER",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "585-586-5166",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "CL017",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00823996",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "PO14939759",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.