Michael Patrick Noonan, M.D.

Individual provider Active NPI Dermatology Physician · Trumbull, CT

NPI 1609892371 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1609892371
Entity type
Individual (NPI type 1)
Primary specialty
Dermatology Physician 207N00000X
License
032208 (CT)
Practice address
160 Hawley LN
Trumbull, CT 06611-5300
Phone
(203) 377-0639
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Dermatology
Education
New York University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adult and Pediatric Dermatology Specialists, P.C. (10 clinicians)

Practice addresses (Care Compare)

160 Hawley LN
Suite 104
Trumbull, CT 06611-5379
Phone (203) 377-0639

Merit-based Incentive Payment System (MIPS)

Final score
65.6 of 100 (group)
Quality
31.19
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1907
Removal or shaving of skin growth18
Skin biopsy257

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100624000136 CT Practitioner - Dermatology 2466513163 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
032208CTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adult & Pediatric Dermatology Specialists, P.C. Dermatology Current
since Dec 1, 1991
Accepting new patients
Adult & Pediatric Dermatology Specialists, P.C. Dermatology Current
since Dec 1, 1991
Accepting new patients

Locations

299 Seymour Ave
Derby, CT 06418
Phone (203) 377-0639

160 Hawley Ln
Ste 104
Trumbull, CT 06611
Phone (203) 377-0639

160 Hawley Ln
Trumbull, CT 06611
Phone (203) 375-3456

162 Kings Hwy N
Westport, CT 06880
Phone (203) 222-0198

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 032208 CT Yes

Addresses

Primary practice location

160 Hawley LN
Trumbull, CT 06611-5300

Mailing address

160 Hawley LN
Trumbull, CT 06611-5300
Phone (203) 377-0639

Other providers in Trumbull, CT

All providers in Trumbull, CT · Dermatology Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.