NPIMap

Individual provider Active NPI

Michael Christoph Muelly, M.D.

  • Diagnostic Radiology Physician
  • Stanford, CA
National Provider Identifier
1588957336
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A122385 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
May 25, 2011
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X S2646 TX
Diagnostic Radiology Physician 2085R0202X A122385 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

2825 Oak Lawn Ave Unit 192749
Dallas, TX 75219-4688
Phone (510) 683-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, IN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160809003201 CA Practitioner - Diagnostic Radiology 2264726561 Reassigns benefits to 3 organizations
I20191122001686 TX Practitioner - Diagnostic Radiology 2264726561 Reassigns benefits to 1 organization
I20240126002572 IN Practitioner - Diagnostic Radiology 2264726561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Pennsylvania State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone (925) 847-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Medical Imaging - Southlake, LLC CurrentSince Jun 1, 2021 Accepting new patients
Stanford Health Care Diagnostic Radiology CurrentSince Jun 15, 2016 Accepting new patients
Stanford Health Care Diagnostic Radiology Current Accepting new patients
Midtown Medical Imaging - Alliance CurrentSince Jul 10, 2019 Accepting new patients
Stanford Health Care CurrentSince Jun 15, 2016 Accepting new patients
Imvaria Labs LLC CurrentSince Jun 10, 2024 Accepting new patients
Ramic Fort Worth, LLC CurrentSince Jul 10, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
East Texas Radiology Consultants Diagnostic Radiology Past Accepting new patients
Kettering Medical Center Past Accepting new patients
Alliance Physicians Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Vision Radiology Professional Limited Liability Company PastSince Sep 15, 2024 Accepting new patients
Kettering Independent Medical Group Inc Past Accepting new patients
Virtual Radiologic Professionals of California, P.a Diagnostic Radiology PastSince Aug 1, 2017 Accepting new patients

Locations

1804 Embarcadero Rd
Ste 100
Palo Alto, CA 94303
Phone (650) 497-9067

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

300 Pasteur Dr
#5621
Stanford, CA 94305
Phone (206) 583-6079

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

3030 Waterview Pkwy
Richardson, TX 75080
Phone (972) 669-7070

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1588957336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 OAK LAWN AVE UNIT 192749",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194688",
            "telephone_number": "510-683-9500",
            "fax_number": "877-880-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLY",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-25",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "S2646",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A122385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.