DR. MARC J MIHALKO M.D.
NPI 1568459345
Orthopaedic Surgery in Germantown, TN

Active since October 05, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138(901) 759-3100 Get Directions Write a Review

NPPES record last updated: May 1, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Marc J Mihalko M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARC J MIHALKO M.D. (NPI 1568459345) is an individual orthopaedic surgery provider in Germantown, Tennessee, licensed in Tennessee (36579) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospitals Of Memphis, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1998).

NPPES Registry Identity

NPI1568459345
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. MARC J MIHALKOCredential: M.D.
Location Address1400 S GERMANTOWN RDGermantown, TN 38138-2205
Mailing Address1400 S Germantown RdGermantown, TN 38138-2205 · (901) 759-3100
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1998
Enumeration DateOctober 5, 2005
Last NPPES UpdateMay 1, 2018
NPI 1568459345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in TN · 36579
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1400 S GERMANTOWN RD, Germantown, TN 38138

Other Identifiers 3

Medicaid3874530TN
Medicaid01473008MS
Medicaid165776001AR

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Marc J Mihalko M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597678946
PECOS Enrollment IDI20031113000076, I20101214000165
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 34

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg J7325
Synvisc or Synvisc-One is a treatment involving an injection of a substance called hyaluronan into your joints. This substance, naturally found in the body, helps lubricate and cushion your joints, reducing pain and improving mobility. It's often used for arthritis patients.
2,499 services36 patients
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110
This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
1,024 services403 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
982 services480 patients
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112
This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.
636 services291 patients
Injection, methylprednisolone acetate, 40 mg J1030
Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.
576 services189 patients
X-ray of knee, 3 views 73562
An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
551 services374 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Hospitals Of Memphis

Acute Care Hospitals · Memphis, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number440049
Location1265 Union Ave Suite 700Memphis, TN 38104 · Shelby County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38138 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Cane, includes canes of all materials, adjustable or fixed, with tip E0100
DME-Other DME · category DE000N
1 supplier15 claims15 services$18.49 avg. paid by Medicare
Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
2 suppliers40 claims40 services$47.15 avg. paid by Medicare
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment L1820
DME-Orthotic Devices · category DF011N
1 supplier40 claims42 services$97.38 avg. paid by Medicare
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf L1830
DME-Orthotic Devices · category DF011N
1 supplier45 claims45 services$71.31 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Orthopaedic Surgery
1400 S GERMANTOWN RD
GERMANTOWN, TN 38138
Orthopaedic Surgery
1400 S GERMANTOWN RD
GERMANTOWN, TN 38138
Orthopaedic Surgery
1400 S GERMANTOWN RD
GERMANTOWN, TN 38138
Specialist/Technologist (Athletic Trainer)
1400 S GERMANTOWN RD
GERMANTOWN, TN 38138
Physician Assistant
1400 S GERMANTOWN RD
GERMANTOWN, TN 38138
Physical Therapist
1400 S GERMANTOWN RD
GERMANTOWN, TN 38138
Orthopaedic Surgery (Foot and Ankle Surgery)
1400 S GERMANTOWN RD
GERMANTOWN, TN 38138
Family Medicine (Sports Medicine)
1400 S GERMANTOWN RD
GERMANTOWN, TN 38138

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marc Mihalko's NPI number?

The NPI number for Marc Mihalko is 1568459345. It was assigned to this individual provider in the NPPES registry on October 5, 2005.

Where is Marc Mihalko located?

Marc Mihalko practices at 1400 S Germantown Rd, Germantown, TN 38138. The listed phone number is (901) 759-3100.

What is Marc Mihalko's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Marc Mihalko enrolled in Medicare?

Yes. Marc Mihalko is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Marc Mihalko accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 6 other insurers list Marc Mihalko as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Marc Mihalko affiliated with any hospitals?

According to CMS data, Marc Mihalko is affiliated with Methodist Hospitals Of Memphis.

When was this NPI record last updated?

The NPPES record for Marc Mihalko was last updated on May 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.