Michael John Ulissey, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD6023722 Issued in WA

Practice address

1268 E Main St
Suite 1
Auburn, WA 98002-5748

Phone

(253) 735-1991

Fax

(253) 735-8837

NPI assigned

Apr 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, AZ2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Texas a & M University System, HSC, College of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Diagnostic Radiology Group LLCGroup PAC ID 1658796859, 62 clinicians

Innovative Radiology PAGroup PAC ID 2668432782, 39 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.25 of 100Reported as group

Quality

75

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Arizona Diagnostic Radiology Group, LLC

  • Diagnostic Radiology Physician
  • Gilbert, AZ
  • NPI 1336757699
  Medicare reassignment Care Compare group NPD
• Innovative Radiology PA

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1568400810

  AZ

  Medicare reassignment Care Compare group NPD
• Medical Scanning Consultants PA

  dba RAYUS Radiology

  • Diagnostic Radiology Physician
  • Federal Way, WA
  • NPI 1730156175
  Medicare reassignment
• Medical Scanning Consultants PA

  dba RAYUS Radiology

  • Diagnostic Radiology Physician
  • Lakewood, WA
  • NPI 1518995646
  NPD

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1366406092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 E MAIN ST",
            "address_2": "SUITE 1",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025748",
            "telephone_number": "253-735-1991",
            "fax_number": "253-735-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 E MAIN ST",
            "address_2": "SUITE 1",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025748",
            "telephone_number": "253-735-1991",
            "fax_number": "253-735-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULISSEY",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD6023722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7117252",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Turner, MD
• Jaclyn Turpening, RN
• Jennie Tutino
• Wendy Tyau-Dumlao
• Itoro Akpan Ukpe
• Unitypathservices
• Universal Treatment Center, Inc (Auburn Regional Center for Cancer Care)
• John Unsicker, LD
• Chance Unterseher, CPC
• Nahjae E Upshaw, NP

• Diagnostic Radiology Physician in Auburn, WA
• Providers in Auburn, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.

Verify at the official NPI Registry.