Individual provider Active NPI

Martha S Housholder, M.D.

  • Dermatopathology Physician
  • Wichita, KS
National Provider Identifier
1508848144
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
15402 Issued in KS
Practice address
835 N Hillside St
Wichita, KS 67214-4913
Phone
(316) 685-4395
Fax
(316) 685-1149
NPI assigned
Nov 18, 2005
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 15402 KS Primary

Addresses

Primary practice location

835 N Hillside St
Wichita, KS 67214-4913

Mailing address

835 N Hillside St
Wichita, KS 67214-4913
Phone (316) 685-4395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20050414000839 KS Practitioner - DermatologyPractitioner - Pathology 2567409139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
University of Kansas School of Med (KC/Wich/Sal), 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Dermatology Clinic P aGroup PAC ID 4688621451, 6 clinicians

Practice addresses (Care Compare)

1410 N Woodlawn Blvd
Suite E
Derby, KS 67037-2954
Phone (316) 685-4395

835 N Hillside St
Wichita, KS 67214-4913
Phone (316) 685-4395

Merit-based Incentive Payment System (MIPS)

Final score
77.55 of 100Reported as group
Quality
55.09
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions2343
Removal of nail tissue1-10
Removal or shaving of skin growth258
Skin biopsy31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15402KSMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Dermatology Clinic, P a Dermatopathology CurrentSince Jul 20, 1978 Accepting new patients

Locations

835 N Hillside St
Wichita, KS 67214
Phone (316) 247-6451

Interoperability endpoints

  • Direct secure messaging: martha.housholder.1@15396.direct.athenahealth.com
  • Direct secure messaging: martha.housholder@khindirect.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1508848144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144913",
            "telephone_number": "316-685-4395",
            "fax_number": "316-685-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144913",
            "telephone_number": "316-685-4395",
            "fax_number": "316-685-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSHOLDER",
        "first_name": "MARTHA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "KS",
            "license": "15402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.