Individual provider Active NPI

Michael S. Kolodney, M.D.

  • Dermatology Physician
  • Torrance, CA
National Provider Identifier
1740243815
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G86310 Issued in CA
Practice address
21840 Normandie Ave
Torrance, CA 90502-2047
Phone
(310) 222-5015
Fax
(310) 328-1415
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G86310 CA Primary

Addresses

Primary practice location

21840 Normandie Ave
Torrance, CA 90502-2047

Mailing address

21840 Normandie Ave
Torrance, CA 90502-2047
Phone (310) 222-5015

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mkolodney45123@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address mkolodney45123@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address mkolodney45123@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161031000542 WV Practitioner - Dermatology 6103711304 Reassigns benefits to 1 organization
I20211021003246 MD Practitioner - Dermatology 6103711304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Washington University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

375 Pythian Ave
Oakland, MD 21550-5111
Phone (301) 334-4565

6040 University Town Centre Dr
Morgantown, WV 26501-2421
Phone (304) 285-7222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions245
Removal or shaving of skin growth1-10
Skin biopsy113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G86310CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Garrett County, LLC CurrentSince Mar 8, 2025 Accepting new patients
Specialty Physicians of Garrett County, LLC CurrentSince Mar 8, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jul 24, 2021 Accepting new patients
Wvu Med Corp Cheat Lake Physicians CurrentSince Aug 22, 2016 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 22, 2016 Accepting new patients
Harbor-UCLA Medical Foundation, Inc Past Accepting new patients

Locations

375 Pythian Ave
Oakland, MD 21550
Phone (301) 334-0585

880 Memorial Dr
Lowr Level
Oakland, MD 21550
Phone (301) 334-1177

251 N 4th St
Oakland, MD 21550
Phone (301) 533-4000

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

6040 University Town Centre Dr
Morgantown, WV 26501

Interoperability endpoints

  • Direct secure messaging: mkolodney45123@direct.wvuhsdirect.com

Organizations & group practices 6

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1740243815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21840 NORMANDIE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022047",
            "telephone_number": "310-222-5015",
            "fax_number": "310-328-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21840 NORMANDIE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022047",
            "telephone_number": "310-222-5015",
            "fax_number": "310-328-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODNEY",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G86310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkolodney45123@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkolodney45123@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkolodney45123@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.