Individual provider Active NPI

Jeffrey Allen Muldoon, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Holland, MI
National Provider Identifier
1720460629
Registry record updated Sep 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901002572 Issued in MI
Practice address
904 S Washington Ave
Holland, MI 49423-7724
Phone
(616) 392-7472
Fax
(616) 392-3327
NPI assigned
Jun 26, 2015
Last updated
Sep 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901002572 MI Primary

Addresses

Primary practice location

904 S Washington Ave
Holland, MI 49423-7724

Mailing address

904 S Washington Ave
Holland, MI 49423-7724
Phone (616) 392-7472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620000852 MI Practitioner - Podiatry 9638424468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

904 S Washington Ave
Suite 130
Holland, MI 49423-7724
Phone (616) 392-7472

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.29 of 100Reported as group
Quality
80.78
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue70
Removal of skin lesions1-10
Removal of nail tissue562
Removal or shaving of skin growth262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901002572MIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Foot and Ankle Center PC Foot & Ankle Surgery CurrentSince Jul 16, 2018 Accepting new patients
Holland Foot and Ankle Center PC Foot & Ankle Surgery CurrentSince Jul 16, 2018 Accepting new patients
West Michigan Surgical Center, LLC Past Accepting new patients

Locations

516 Linn St
Allegan, MI 49010
Phone (269) 673-5200

445 120th Ave
Holland, MI 49424
Phone (616) 738-1300

904 Washington Ave
Holland, MI 49423
Phone (616) 392-7472

904 Washington Ave
Ste 130
Holland, MI 49423
Phone (616) 252-5950

300 S State St
Ste 3
Zeeland, MI 49464
Phone (616) 344-6630

Interoperability endpoints

  • Direct secure messaging: jmuldoon@hollandfoot.emadirect.md

Organizations & group practices 3

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 2

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1720460629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 S WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237724",
            "telephone_number": "616-392-7472",
            "fax_number": "616-392-3327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 S WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237724",
            "telephone_number": "616-392-7472",
            "fax_number": "616-392-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDOON",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-26",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.