Michael D Michener, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

129488 Issued in AK

Practice address

3841 Piper St Ste T4-020
Anchorage, AK 99508-4673

Phone

(907) 646-8500

Fax

(907) 646-9760

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Dermatology

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mike@alaskaderm.emadirect.md

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.

• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Anchorage, AK
  • NPI 1124670088
  Medicare reassignment Care Compare group NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994
  NPD
• Dermatology Associates,P.C.

  • Specialist
  • Tigard, OR
  • NPI 1851442461
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1467448662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST STE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084673",
            "telephone_number": "907-646-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST STE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084673",
            "telephone_number": "907-646-8500",
            "fax_number": "907-646-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHENER",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036114135",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-114135",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AK",
            "license": "129488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle B. Burch- Speech-Language Pathologist
• Michelle Bauer
• Michelle Randolph MD PC
• Michelle Thomas MD
• Marion M Michener
• Esther Micua
• Aaron Middlekauff, PHARM.D.
• Erika Gladys Middleton
• Midnight Sun Home Care Inc
• Midnight Sun Medical Supplies, LLC

• Dermatology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dermatology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.