NPIMap

Individual provider Active NPI

Micalyn D Baney, DO

  • Family Medicine Physician
  • Waterford, PA
National Provider Identifier
1467579011
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS014005 Issued in PA
Practice address
220 E 3Rd St
Waterford, PA 16441
Phone
(814) 796-6791
Fax
(814) 796-6517
NPI assigned
Mar 26, 2007
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS014005 PA Primary

Addresses

Primary practice location

220 E 3Rd St
Waterford, PA 16441

Mailing address

1 Lecom PL
Erie, PA 16505-2571

Other identifiers 1

IdentifierTypeStateIssuer
1019257770001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000283 PA Practitioner - Family Practice 1153422845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millcreek Community HospitalGroup PAC ID 8426020173, 67 clinicians

Practice addresses (Care Compare)

220 E 3Rd St
Waterford, PA 16441-9753
Phone (814) 796-6791

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS014005PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millcreek Community Hospital Family Medicine Current Accepting new patients
Medical Associates of Erie Family Medicine CurrentSince Jul 1, 2007 Accepting new patients
Millcreek Community Hospital Family Medicine CurrentSince Jun 13, 2025 Accepting new patients
Millcreek Community Hospital CurrentSince Jun 13, 2025 Accepting new patients
Medical Associates of Erie Family Medicine CurrentSince Jul 1, 2007 Accepting new patients

Locations

1 Lecom Pl
Erie, PA 16505

2625 Parade St
Erie, PA 16504
Phone (814) 452-6383

5515 Peach St
Erie, PA 16509
Phone (814) 864-4031

218 E 3rd St
Waterford, PA 16441
Phone (814) 796-6791

220 E 3rd St
Waterford, PA 16441
Phone (814) 796-6791

Organizations & group practices 5

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1467579011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LECOM PL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052571",
            "fax_number": "814-868-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E 3RD ST",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "16441",
            "telephone_number": "814-796-6791",
            "fax_number": "814-796-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANEY",
        "first_name": "MICALYN",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2023-03-01",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS014005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019257770001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, PA

Sources for this page

Verify at the official NPI Registry.