Individual provider Active NPI

Mariam Totonchy

  • Dermatology Physician
  • New Haven, CT
National Provider Identifier
1861839383
Registry record updated Apr 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
56347 Issued in CT
Practice address
20 York St
Yale-New Haven Hospital
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
May 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X AY2629155 CT
Dermatology Physician 207N00000X 56347 CT Primary

Addresses

Primary practice location

20 York St
Yale-New Haven Hospital
New Haven, CT 06510-3220

Mailing address

333 Cedar Street Lci 501
Yale School of Medicine, Department of Dermatology
New Haven, CT 06520-8059
Phone (203) 785-4092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190625003047 WA Practitioner - Dermatology 1658690011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, Geffen School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Surgery Center, P.S.Group PAC ID 2567456882, 4 clinicians

Practice addresses (Care Compare)

1229 Madison St
Suite 1480
Seattle, WA 98104-3538
Phone (206) 346-6647

Merit-based Incentive Payment System (MIPS)

Final score
93.56 of 100Reported as group
Quality
87.12
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision159
Removal of skin lesions51
Removal of skin cancer677
Skin biopsy53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AY2629155CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Surgery Center, P.S. CurrentSince Jun 1, 2019 Accepting new patients
North Pacific Dermatology PS CurrentSince Oct 7, 2022 Accepting new patients
Skin Surgery Center PS CurrentSince Jun 1, 2019 Accepting new patients

Locations

1200 112th Ave NE
Ste C187
Bellevue, WA 98004
Phone (425) 457-4900

1551 116th Ave NE
Ste A
Bellevue, WA 98004
Phone (425) 453-8647

1229 Madison St
Ste 1480
Seattle, WA 98104
Phone (206) 346-6647

Interoperability endpoints

  • Direct secure messaging: mtotonchy@directaddress.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493510400000",
    "number": "1861839383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR STREET LCI 501",
            "address_2": "YALE SCHOOL OF MEDICINE, DEPARTMENT OF DERMATOLOGY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208059",
            "telephone_number": "203-785-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YALE-NEW HAVEN HOSPITAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOTONCHY",
        "first_name": "MARIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2017-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "AY2629155",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "56347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.