Active NPI
Mark J Zalla, M.D.
- Dermatology Physician
- Florence, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 35119
- 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, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000223589 | Other | KY | ANTHEM ID |
| 2815155 | Other | AETNA ID | |
| 03-20159 | Other | UNITED 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
Enrollment records 1
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
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 100
- Quality
- 83.58
- Promoting interoperability
- 86
- Improvement activities
- 40
- Cost
- 89.35
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 41 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 55 |
| Removal of skin cancer | 387 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 48 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35119 | KY | MD | MOHS-Micrographic Surgery Physician |
| K35119 | KY | MD | Procedural Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology Associates of Northern Kentucky PSC | Current | Accepting new patients | |
| Proven Cosmetic Dermatology | Dermatology | Past | 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.
-
- Dermatopathology Physician
- Florence, KY
- NPI 1629197397
-
dba Dermatology Aesthetics of Northern Kentucky
- Dermatology Physician
- Florence, KY
- NPI 1811663198
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.