Individual provider Active NPI

Gregory John Fulchiero Jr., M.D., M.S.

  • MOHS-Micrographic Surgery Physician
  • Altoona, PA
National Provider Identifier
1942414115
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD432947 Issued in PA
Practice address
2525 9TH Ave Ste 2a
Altoona, PA 16602-2014
Phone
(814) 943-7546
Fax
(814) 943-7543
NPI assigned
May 9, 2007
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 MD432947 PA
MOHS-Micrographic Surgery Physician 207ND0101X MD432947 PA Primary
Dermatopathology Physician 207ND0900X MD432947 PA
Procedural Dermatology Physician 207NS0135X MD432947 PA

Addresses

Primary practice location

2525 9TH Ave Ste 2a
Altoona, PA 16602-2014

Mailing address

2525 9TH Ave
Suite 2a
Altoona, PA 16602-2014
Phone (814) 943-7546

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
I20080523000245 PA Practitioner - DermatologyPractitioner - Surgical Oncology 9335218890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Surgical Oncology
Education
Temple University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Dermatology and Center for Skin Surgery, LLCGroup PAC ID 4385714765, 2 clinicians

Practice addresses (Care Compare)

2525 9TH Ave
Suite 2a
Altoona, PA 16602-2014
Phone (814) 943-7546

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.27 of 100Reported as individual
Quality
80.55
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision96
Removal of tissue21
Removal of skin lesions2874
Removal of skin cancer672
Removal of nail tissue1-10
Removal or shaving of skin growth53
Skin biopsy1314

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Dermatology & Center for Skin Surgery, LLC Dermatology CurrentSince May 12, 2008 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2525 9th Ave
Ste 2A
Altoona, PA 16602
Phone (814) 941-7170

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1942414115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 9TH AVE",
            "address_2": "SUITE 2A",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166022014",
            "telephone_number": "814-943-7546",
            "fax_number": "814-943-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 9TH AVE STE 2A",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166022014",
            "telephone_number": "814-943-7546",
            "fax_number": "814-943-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULCHIERO",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD432947",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "PA",
            "license": "MD432947",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "PA",
            "license": "MD432947",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "PA",
            "license": "MD432947",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.