Clinzo P Mickle Ii (NPI# 1104096361, PAC ID# 6406027564) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1104096361 |
| PAC ID by PECOS | 6406027564 |
| Professional Enrollment ID | I20121018000352 |
| Full Name | Clinzo P Mickle Ii |
| Organization Legal Name | INTEGRATED DERMATOLOGY OF 19TH STREET LLC |
| Address |
1145 19th St Nw Suite 301 Washington DC 20036-3718 |
| Phone Number | 2029556995 |
| Gender | M |
| Medical School | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Graduation Year | 2002 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 2567626567 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 | 2029556995 | INTEGRATED DERMATOLOGY OF 19TH STREET LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 100% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 100% | |
| MIPS_EC_265_overall | Biopsy Follow-Up | 100% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 29% |
| Organization Legal Name | INTEGRATED DERMATOLOGY OF 19TH STREET LLC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren M Craig | Dermatology | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Nicole Marie Masson | Physician Assistant | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Farhaad Rahman Riyaz | Dermatology | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Urvi P Gonzales | Dermatology | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Vicky Phan | Physician Assistant | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Agnes J Chang | Dermatology | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Garry C Jelen | Physician Assistant | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Street Address |
1145 19TH ST NW SUITE 301 |
| City | WASHINGTON |
| State | DC |
| Zip | 20036-3718 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tolulope A Agunbiade | Cardiovascular Disease (cardiology) | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Lauren M Craig | Dermatology | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Roshiel D Tiu | Obstetrics/gynecology | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Justin A Mullner | Family Medicine | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Emerson L Coronel | Internal Medicine | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Michael Gillespie | General Surgery | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Christopher J Mays | Internal Medicine | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Emmanuella Maria Eastman | Podiatry | Foot and Ankle Specialists of The Mid Atlantic LLC | 1145 19th St Nw, Suite 605, Washington, DC 20036-3731 |
| Luther Lorenzo Ampey Iii | Radiation Oncology | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Behzad Doratotaj | Hematology/oncology | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aisha R Riley | Nurse Practitioner | 2001 Massachusetts Nwave, Washington, DC 20036-1011 | |
| Nyeesha N Thompson | Nurse Practitioner | Eric C. Marshall Md PC | 6 Dupont Cir Nw, Minuteclinic Diagnostic of Dc, Washington, DC 20036-1108 |
| Tara Devineni | Clinical Social Worker | Tara Devineni, Licsw, LLC | 1555 Connecticut Ave Nw, Washington, DC 20036-1111 |
| Eric C Bergman | Psychiatry | 1555 Connecticut Ave Nw, Suite 300w, Washington, DC 20036-1125 | |
| Carrie E Renfro | Clinical Social Worker | Family Matters of Greater Washington | 1509 16th St Nw, Washington, DC 20036-1461 |
| Jorge A Membreno | Clinical Social Worker | Family Matters of Greater Washington | 1509 16th St Nw, Washington, DC 20036-1461 |
| Trinaty N Fofana | Clinical Social Worker | Family Matters of Greater Washington | 1509 16th St Nw, Washington, DC 20036-1461 |
| Mary R Cuevas | Clinical Social Worker | Family Matters of Greater Washington | 1509 16th St Nw, Washington, DC 20036-1461 |
| Cheryl Tran | Optometry | Miller Eyecare Annapolis Dc, LLC | 1330 Connecticut Nwave, Washington, DC 20036-1704 |
| Chales Gamboa | Optometry | Miller Eyecare Annapolis Dc, LLC | 1330 Connecticut Nwave, Washington, DC 20036-1704 |
| Find all physicians in zip 20036 | |||
| City | WASHINGTON |
| Zip Code | 20036 |
| Specialty | DERMATOLOGY |
| City + Specialty | WASHINGTON + DERMATOLOGY |
Please comment or provide details below to improve the information on Clinzo P Mickle Ii.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.