Individual provider Active NPI

Michael Jude Welsch, MD

  • Dermatology Physician
  • Lombard, IL
National Provider Identifier
1932175767
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036110217 Issued in IL
Practice address
820 Springer Dr
Lombard, IL 60148-6413
Phone
(815) 744-8554
NPI assigned
Feb 23, 2006
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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 39686 KY
Dermatology Physician 207N00000X 01055117A IN
Dermatology Physician 207N00000X 39928 TN
Dermatology Physician 207N00000X 036110217 IL Primary

Addresses

Primary practice location

820 Springer Dr
Lombard, IL 60148-6413

Mailing address

820 Springer Dr
Lombard, IL 60148-6413
Phone (815) 744-8554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IL, MI, IN, VA, WV, NC, DC, CA9 enrollments
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 9

Enrollment IDStateProvider typePAC IDDetails
I20080505000333 TN Practitioner - DermatologyPractitioner - Pathology 8820017205 Reassigns benefits to 1 organization
I20110426000373 IL Practitioner - Dermatology 8820017205 Reassigns benefits to 1 organization
I20190618002047 MI Practitioner - DermatologyPractitioner - Pathology 8820017205 Reassigns benefits to 1 organization
I20200528002841 IN Practitioner - Dermatology 8820017205 Reassigns benefits to 1 organization
I20201014002828 VA Practitioner - Dermatology 8820017205 Reassigns benefits to 1 organization
I20201014002966 WV Practitioner - Dermatology 8820017205
I20201026003246 NC Practitioner - Dermatology 8820017205 Reassigns benefits to 2 organizations
I20210216001007 DC Practitioner - DermatologyPractitioner - Pathology 8820017205
I20260320000035 CA Practitioner - Dermatology 8820017205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6605 Nancy Ridge Dr
San Diego, CA 92121-2253

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110217ILMDDermatology Physician
01055117AINMDDermatology Physician
39686KYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Soderstrom Dermatology Center S C CurrentSince Aug 1, 2024 Accepting new patients
Audrey Bruell, M.D. P.C. Dermatology Current Accepting new patients
Skin Surgery Center PA Dermatology CurrentSince Mar 1, 2023 Accepting new patients
Dermatology and Plastic Surgery Associates, S.C. CurrentSince Apr 27, 2020 Accepting new patients
Soderstrom Dermatology Center S C Dermatology CurrentSince Aug 1, 2024 Accepting new patients
Skin Surgery Center PA CurrentSince Mar 1, 2023 Accepting new patients
Robert M Soderstrom MD PC Dermatology Past Accepting new patients
Academic Dermatology,PC PastSince Jan 18, 2019 Accepting new patients
West Kentucky Dermatology, PSC Dermatology PastSince Jan 17, 2021 Accepting new patients
West Kentucky Dermatology, PSC Dermatology Past Accepting new patients

Locations

1124 Essington Rd
Ste A
Joliet, IL 60435

2100 Jacobssen Dr
Normal, IL 61761
Phone (309) 268-9980

4909 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 674-7546

3501 Enterprise Ave
Valparaiso, IN 46383

37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931

10512 Park Rd
Ste 113
Charlotte, NC 28210
Phone (704) 289-9448

701 E Roosevelt Blvd
Ste 200A
Monroe, NC 28112
Phone (704) 282-8276

1450 Professional Park Dr
Winston Salem, NC 27103
Phone (336) 724-2434

Interoperability endpoints

  • Direct secure messaging: mwelsch@directaddress.net

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1932175767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SPRINGER DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486413",
            "telephone_number": "815-744-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 SPRINGER DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486413",
            "telephone_number": "815-744-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELSCH",
        "first_name": "MICHAEL",
        "middle_name": "JUDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "39686",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01055117A",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "39928",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036110217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.