Active NPI
Michael Joseph Michno Jr., MD
- Diagnostic Radiology Physician
- Port Jefferson, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35.152557
- Practice address
- 75 N Country Rd
Port Jefferson, NY 11777-2119 - Phone
- (631) 686-2517
- NPI assigned
- Mar 26, 2018
- Last updated
- Feb 19, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | 35.152557 | OH | Primary |
Addresses
Primary practice location
75 N Country Rd
Port Jefferson, NY 11777-2119
Mailing address
141 Pleasant St # 1
Boston, MA 02125-1525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Tufts University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
338 Spear St
Unit 41E
San Francisco, CA 94105-6165
Phone (937) 395-8627
Hospital & facility affiliations
- Kettering Health Dayton
- Springfield Regional Medical Center
- Kettering Health Main Campus
- Soin Medical Center
- Kettering Health Miamisburg
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.33 of 100
- Quality
- 77.37
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.67 of 100
- Quality
- 84.1
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.152557 | OH | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Santa Clara | Current | Accepting new patients | |
| Bay Imaging Consultants Medical Group Inc | Diagnostic Radiology | Current | Accepting new patients |
| Kettering Network Radiologists Inc | Diagnostic Radiology | Current | Accepting new patients |
| Bay Imaging Consultants Medical Group Inc | Diagnostic Radiology | Current | Accepting new patients |
| Henry County Hospital Inc | Current | Accepting new patients | |
| Magnetic Imaging Affiliates, LLC | Diagnostic Radiology | Current | Accepting new patients |
| County of Santa Clara | Current | Accepting new patients | |
| County of Santa Clara | Current | Accepting new patients | |
| County of Santa Clara | Current | Accepting new patients | |
| Bay Imaging Consultants Medical Group Inc | Diagnostic Radiology | Current | Accepting new patients |
| County of Santa Clara | Current | Accepting new patients | |
| County of Santa Clara | Current | Accepting new patients | |
| John Muir Call Coverage Medical Group, Inc. | Past | Accepting new patients | |
| Northbay Healthcare Group | Past | Accepting new patients |
Locations (25 of 27)
3901 Lone Tree Way
Antioch, CA 94509
Phone (925) 779-7200
2001 Dwight Way
Berkeley, CA 94704
Phone (510) 204-1880
2400 Balfour Rd
Brentwood, CA 94513
Phone (925) 308-8100
2540 East St
Concord, CA 94520
Phone (925) 674-2228
1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600
7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400
15400 National Ave
Ste 200
Los Gatos, CA 95032
Phone (408) 358-8414
3100 Summit St
Oakland, CA 94609
Phone (510) 869-8377
350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000
5730 Telegraph Ave
Oakland, CA 94609
Phone (510) 204-1507
12 Camino Encinas
Orinda, CA 94563
Phone (510) 204-8180
140 Brookwood Rd
Ste 100
Orinda, CA 94563
Phone (925) 254-9090
1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320
1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846
2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050
225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051
2425 Samaritan Dr
San Jose, CA 95124
Phone (408) 354-2114
500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433
750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320
751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110
660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366
1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000
300 Hospital Dr
#1112
Vallejo, CA 94589
Phone (707) 554-4107
1450 Treat Blvd
Walnut Creek, CA 94597
Phone (925) 308-8299
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545
Interoperability endpoints
- mmichno683874@hisp.ehr.sutterhealth.org
Organizations & group practices 14
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.
-
- Diagnostic Radiology Physician
- Walnut Creek, CA
- NPI 1356597637
-
dba SCVMC Physician Services
- Anesthesiology Physician
- San Jose, CA
- NPI 1588721500
-
dba Valley Health Center Alexian
- Federally Qualified Health Center (FQHC)
- San Jose, CA
- NPI 1629301346
-
dba Josefina Narvaez Mental Health Center MH Aoa
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San Jose, CA
- NPI 1699885079
-
- Critical Access Hospital
- Napoleon, OH
- NPI 1407880909
-
- Diagnostic Radiology Physician
- Oakland, CA
- NPI 1487040770
-
- Diagnostic Radiology Physician
- Saint Helena, CA
- NPI 1063909851
-
- Diagnostic Radiology Physician
- Berkeley, CA
- NPI 1871749754
-
dba Valley Health Center Lundy
- Federally Qualified Health Center (FQHC)
- San Jose, CA
- NPI 1043354020
-
- Federally Qualified Health Center (FQHC)
- Gilroy, CA
- NPI 1922093533
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Soin Medical Center
- General Acute Care Hospital
- Beavercreek, OH
- NPI 1760764849
-
dba Mercy Health - Springfield Regional Medical Center
- General Acute Care Hospital
- Springfield, OH
- NPI 1144286402
-
dba Mercy Health - Lab Services, Springfield
- Clinical Medical Laboratory
- Springfield, OH
- NPI 1477217297
Hospital
-
dba Kettering Health Dayton
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
dba Kettering Health Main Campus
- General Acute Care Hospital
- Kettering, OH
- NPI 1043233984
-
dba Kettering Health Miamisburg
- General Acute Care Hospital
- Miamisburg, OH
- NPI 1316966518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1407351182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 PLEASANT ST # 1",
"city": "BOSTON",
"state": "MA",
"postal_code": "021251525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 N COUNTRY RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117772119",
"telephone_number": "631-686-2517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHNO",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-26",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35.152557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.