Michael James McDermott, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G73655 Issued in CA

Practice address

1405 Montgomery Dr
Santa Rosa, CA 95405-4557

Phone

(707) 546-1922

Fax

(707) 546-1897

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Creighton University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Healdsburg Hospital Hospital, Healdsburg, CA, CCN 051321
• Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136

Merit-based Incentive Payment System (MIPS)

Final score

68.05 of 100Reported as group

Quality

62.72

Promoting interoperability

100

Improvement activities

0

Cost

77.82

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Santa Rosa Orthopaedic Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Santa Rosa, CA
  • NPI 1518907336
  Medicare reassignment NPD
• Santa Rosa Orthopaedic Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Petaluma, CA
  • NPI 1891450920
  NPD
• Northern California Medical Assoc Inc

  • Cardiovascular Disease Physician
  • Lakeport, CA
  • NPI 1235138926
  NPD (past)

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

• Norcal Healthconnect LLC

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645
  Care Compare affiliation
• Norcal Healthconnect LLC

  • Multi-Specialty Clinic/Center
  • Healdsburg, CA
  • NPI 1720695547

  Hospital

  Care Compare affiliation
• Norcal Healthconnect LLC

  • Critical Access Hospital
  • Healdsburg, CA
  • NPI 1861009672
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1750365102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054557",
            "telephone_number": "707-546-1922",
            "fax_number": "707-546-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054557",
            "telephone_number": "707-546-1922",
            "fax_number": "707-546-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G73655",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "G73655",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G736550",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DME",
            "identifier": "00G736553",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G73655",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McCully Atlas Spinal Care Chiropractic, P.C.
• Patrick Wayne McCully
• Nancy L McCune
• Marie Antoinette McCurry
• Kimberly Jane McDermott
• Michael McDonagh, RPH
• Laura M McDonald, APRN
• Marcia L. S. McDonald, FNP CNM
• Maureen Christina McDonald, RN, MS, CNS
• Sharon Jean McDonald, RNFA

• Orthopaedic Surgery Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.