NPIMap

Individual provider Active NPI

Michael P. Muldoon, M.D.

  • Orthopaedic Surgery Physician
  • San Diego, CA
National Provider Identifier
1356428148
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G70877 Issued in CA
Practice address
3750 Convoy St
Suite 201
San Diego, CA 92111-3738
Phone
(858) 278-8300
Fax
(858) 278-1708
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G70877 CA Primary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X G70877 CA

Addresses

Primary practice location

3750 Convoy St
Suite 201
San Diego, CA 92111-3738

Mailing address

3750 Convoy St
Suite 201
San Diego, CA 92111-3738
Phone (858) 278-8300

Other identifiers 1

IdentifierTypeStateIssuer
00G708770MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040122000537 CA Practitioner - Orthopedic Surgery 3678475431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3750 Convoy St
Suite 201
San Diego, CA 92111-3770
Phone (858) 278-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement21
Knee replacement21
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G70877CAMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Orthopedic Specialists, Inc. Orthopaedic Surgery CurrentSince Sep 24, 2018 Accepting new patients
Synergy Orthopedic Specialists, Inc. CurrentSince Sep 24, 2018 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Feb 11, 2014 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Palomar Health Past Accepting new patients

Locations

5565 Grossmont Center Dr
Ste 256
La Mesa, CA 91942
Phone (619) 421-3400

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

4445 Eastgate Mall
Ste 105
San Diego, CA 92121
Phone (858) 357-9450

3750 Convoy St
Ste 201
San Diego, CA 92111
Phone (858) 278-8031

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

4445 Eastgate Mall
Ste 103
San Diego, CA 92121
Phone (858) 450-7118

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 6

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1356428148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST",
            "address_2": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113738",
            "telephone_number": "858-278-8300",
            "fax_number": "858-278-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST",
            "address_2": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113738",
            "telephone_number": "858-278-8300",
            "fax_number": "858-278-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDOON",
        "first_name": "MICHAEL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G70877",
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "CA",
            "license": "G70877",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G708770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.