Individual provider Active NPI

John K Mulholland, MD

  • Dermatology Physician
  • Bryn Mawr, PA
National Provider Identifier
1912901802
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD418785 Issued in PA
Practice address
919 Conestoga Rd
BLDG 2, Suite 106
Bryn Mawr, PA 19010-1352
Phone
(610) 525-5028
Fax
(610) 525-2494
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD418785 PA Primary
Pediatric Dermatology Physician 207NP0225X MD418785 PA
Procedural Dermatology Physician 207NS0135X MD418785 PA
Dermatopathology Physician 207ND0900X MD418785 PA

Addresses

Primary practice location

919 Conestoga Rd
BLDG 2, Suite 106
Bryn Mawr, PA 19010-1352

Mailing address

919 Conestoga Rd
BLDG 2, Suite 106
Bryn Mawr, PA 19010-1352
Phone (610) 525-5028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20061201000036 PA Practitioner - Dermatology 7810995743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Jefferson Medical College of Thomas Jefferson University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryn Mawr Skin and Cancer LLPGroup PAC ID 8123098324, 10 clinicians

Practice addresses (Care Compare)

919 Conestoga Rd
Suite 106
Bryn Mawr, PA 19010-1352
Phone (610) 525-5028

Merit-based Incentive Payment System (MIPS)

Final score
98.19 of 100Reported as group
Quality
96.72
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision162
Removal of skin lesions1498
Removal of skin cancer393
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1134

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD418785PAMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bryn Mawr Skin & Cancer LLP CurrentSince Sep 5, 2006 Accepting new patients
Pennsylvania Dermatology Partners Inc Dermatology CurrentSince May 15, 2012 Accepting new patients
Andrew K Pollack Dermatology Past Accepting new patients
Atlantic Dermatopathology, LLC Past Accepting new patients
Advanced Dermatology of Pennsylvania, PC Dermatology PastSince Jul 28, 2015 Accepting new patients

Locations

258 Ben Franklin Hwy E
Birdsboro, PA 19508
Phone (610) 288-2918

919 Conestoga Rd
Ste 106
Bryn Mawr, PA 19010
Phone (215) 525-5028

919 Conestoga Rd
Bldg 2
Bryn Mawr, PA 19010
Phone (215) 525-5028

919 Conestoga Rd
Ste 2-106
Bryn Mawr, PA 19010
Phone (610) 525-5028

3855 West Chester Pike
Ste 325
Newtown Square, PA 19073
Phone (610) 337-3111

Organizations & group practices 5

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392595200000",
    "number": "1912901802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CONESTOGA RD",
            "address_2": "BLDG 2, SUITE 106",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101352",
            "telephone_number": "610-525-5028",
            "fax_number": "610-525-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 CONESTOGA RD",
            "address_2": "BLDG 2, SUITE 106",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101352",
            "telephone_number": "610-525-5028",
            "fax_number": "610-525-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHOLLAND",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2014-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD418785",
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "PA",
            "license": "MD418785",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "PA",
            "license": "MD418785",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "PA",
            "license": "MD418785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.