Individual provider Active NPI

Mark J Zalla, M.D.

  • Dermatology Physician
  • Florence, KY
National Provider Identifier
1356460018
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35119 Issued in KY
Practice address
7766 Ewing Blvd
Ste 100
Florence, KY 41042-7538
Phone
(859) 283-1033
Fax
(859) 283-1066
NPI assigned
Mar 27, 2007
Last updated
Dec 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35119 KY Primary
MOHS-Micrographic Surgery Physician 207ND0101X 35119 KY
Procedural Dermatology Physician 207NS0135X K35119 KY

Addresses

Primary practice location

7766 Ewing Blvd
Ste 100
Florence, KY 41042-7538

Mailing address

7766 Ewing Blvd
Ste 100
Florence, KY 41042-7538
Phone (859) 283-1033

Other identifiers 3

IdentifierTypeStateIssuer
000000223589OtherKYANTHEM ID
2815155OtherAETNA ID
03-20159OtherUNITED HEALTHCARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20120131000829 KY Practitioner - Dermatology 0941467112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Louisville School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Northern Kentucky PSCGroup PAC ID 1153304647, 11 clinicians

Practice addresses (Care Compare)

7766 Ewing Blvd
Suite 100
Florence, KY 41042-7537
Phone 8592861033240

Merit-based Incentive Payment System (MIPS)

Final score
88.38 of 100Reported as group
Quality
83.58
Promoting interoperability
86
Improvement activities
40
Cost
89.35

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision41
Removal of tissue1-10
Removal of skin lesions55
Removal of skin cancer387
Removal of nail tissue1-10
Skin biopsy48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35119KYMDMOHS-Micrographic Surgery Physician
K35119KYMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Northern Kentucky PSC CurrentSince Jul 17, 2000 Accepting new patients
Proven Cosmetic Dermatology Dermatology PastSince Aug 28, 2021 Accepting new patients

Locations

7766 Ewing Blvd
Ste 100
Florence, KY 41042
Phone (859) 283-1033

7766 Ewing Blvd
#100
Florence, KY 41042
Phone (859) 283-1033

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1356460018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7766 EWING BLVD",
            "address_2": "STE 100",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410427538",
            "telephone_number": "859-283-1033",
            "fax_number": "859-283-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7766 EWING BLVD",
            "address_2": "STE 100",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410427538",
            "telephone_number": "859-283-1033",
            "fax_number": "859-283-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALLA",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "35119",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": "35119",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "KY",
            "license": "K35119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID",
            "identifier": "000000223589",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "2815155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE ID",
            "identifier": "03-20159",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.