Victor Roman Michalak, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD00024607 Issued in WA

Practice address

295 NE Gilman Blvd
Suite 101
Issaquah, WA 98027-2906

Phone

(425) 391-2500

Fax

(425) 391-6464

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

JS Weill Medical College, Cornell University, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Victor R MichalakGroup PAC ID 8022918994, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Victor R. Michalak, MD

  dba Cosmetic Surgery & Dermatology, Inc.

  • Dermatology Physician
  • Issaquah, WA
  • NPI 1003863416
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922050616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 NE GILMAN BLVD",
            "address_2": "SUITE 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272906",
            "telephone_number": "425-391-2500",
            "fax_number": "425-391-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 NE GILMAN BLVD",
            "address_2": "SUITE 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272906",
            "telephone_number": "425-391-2500",
            "fax_number": "425-391-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALAK",
        "first_name": "VICTOR",
        "middle_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00024607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063817",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Cesare Merli, DPT
• Shantay Merry
• Nathaniel Metzger, LMHC
• Amy Mezulis, PH.D.
• Michael Erickson (Klahanie Eye Care Center)
• Kira Reese Michlitsch
• Carol Rwamba Michuki
• Emily Milhomme
• Miller Family Dermatology, PLLC (Arlo Miller, MD, PhD)
• Haley Corrine Miller-Boren, MC61233358

• Specialist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.