Dominic Neal Mastruserio, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35072392M Issued in OH

Practice address

941 Chatham Lane
Suite 323
Columbus, OH 43221

Phone

(614) 442-6647

Fax

(614) 442-6648

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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

University of Cincinnati College of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

D. Neal Mastruserio, M.D., LLCGroup PAC ID 4789772013, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

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.

• D. Neal Mastruserio, M.D., LLC

  • Procedural Dermatology Physician
  • Columbus, OH
  • NPI 1750570453
  Medicare reassignment Care Compare group NPD Authorized official
• Central Ohio Skin & Cancer Inc

  • Dermatology Physician
  • Sunbury, OH
  • NPI 1083622930
  NPD (past)
• Central Ohio Skin & Cancer Inc

  • Dermatology Physician
  • Westerville, OH
  • NPI 1922016864
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Osu Internal Medicine, LLC

  • Endoscopy Clinic/Center
  • Dublin, OH
  • NPI 1427127919
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1508818386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 CHATHAM LN",
            "address_2": "SUITE 323",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432212416",
            "telephone_number": "614-442-6647",
            "fax_number": "614-442-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 CHATHAM LANE",
            "address_2": "SUITE 323",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43221",
            "telephone_number": "614-442-6647",
            "fax_number": "614-442-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRUSERIO",
        "first_name": "DOMINIC",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35072392M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000130128",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0300516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2309291",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Brewer Masterson
• Lauren Mastic
• Brooke Marie Mastin, MD
• Samantha Mastin, RN
• Michael Mastriana, RN
• Jennifer Jefferis Mastruserio, MD
• Rukya A. Masum
• John P. Maszczak, O.D.
• Maria C Matacia, CCC-SLP
• Stephanie Nicole Matacia, NP

• Dermatology Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.