Individual provider Active NPI

Matthew Werner Muellenhoff, D.O.

  • Procedural Dermatology Physician
  • Grass Valley, CA
National Provider Identifier
1740280650
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
20A7904 Issued in CA
Practice address
126 Glasson Way
Grass Valley, CA 95945-5706
Phone
(530) 272-2303
Fax
(530) 272-9648
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 20A7904 CA Primary
Dermatology Physician 207N00000X 20A7904 CA

Addresses

Primary practice location

126 Glasson Way
Grass Valley, CA 95945-5706

Mailing address

126 Glasson Way
Grass Valley, CA 95945-5706
Phone (530) 272-2303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040908001649 CA Practitioner - Dermatology 5890761084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Derm IncGroup PAC ID 3072589266, 2 clinicians

Practice addresses (Care Compare)

126 Glasson Way
Grass Valley, CA 95945-5706
Phone (530) 272-2303

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision280
Removal of tissue1-10
Removal of skin lesions3463
Removal of nail tissue1-10
Removal or shaving of skin growth38
Skin biopsy601

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7904CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Derm Inc. Dermatology CurrentSince Jun 1, 2004 Accepting new patients

Locations

126 Glasson Way
Grass Valley, CA 95945
Phone (530) 272-2303

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1740280650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455706",
            "telephone_number": "530-272-2303",
            "fax_number": "530-272-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455706",
            "telephone_number": "530-272-2303",
            "fax_number": "530-272-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLENHOFF",
        "first_name": "MATTHEW",
        "middle_name": "WERNER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "20A7904",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "20A7904",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.