Brett W Mikeska, M D

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25552 Issued in OR

Practice address

875 Oak St SE Ste 5070
Salem, OR 97301-3975

Phone

(503) 561-8565

Fax

(503) 561-8560

NPI assigned

Sep 21, 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 OR

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

NephrologyAlso: Internal Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kidney Care Physicians LLCGroup PAC ID 0840283511, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Woodburn Dialysis Dialysis facility, Woodburn, OR, CCN 382516
• DaVita Salem Dialysis Dialysis facility, Salem, OR, CCN 382502
• DaVita Lancaster Drive Dialysis Dialysis facility, Salem, OR, CCN 382577
• Salem Hospital Hospital, Salem, OR, CCN 380051
• Salem Health West Valley Hospital, Dallas, OR, CCN 381308
• Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
• WA PPO C-SNP

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.

• Kidney Care Physicians LLC

  • Nephrology Physician
  • Salem, OR
  • NPI 1467672261
  Medicare reassignment Care Compare group NPD
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  NPD (past)

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

• Dva Healthcare Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Salem, OR
  • NPI 1992767149

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Salem, OR
  • NPI 1821463555

  Dialysis facility

  Care Compare affiliation Name & address match
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation
• Salem Health West Valley

  • Critical Access Hospital
  • Dallas, OR
  • NPI 1245237486
  Care Compare affiliation
• Silverton Health

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Care Compare affiliation

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1003915869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE STE 5070",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013975",
            "telephone_number": "503-561-8565",
            "fax_number": "503-561-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE STE 5070",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013975",
            "telephone_number": "503-561-8565",
            "fax_number": "503-561-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKESKA",
        "first_name": "BRETT",
        "middle_name": "W",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "25552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023097",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mid-Valley Oral, Maxillofacial & Implant Surgery
• Mid-Willamette Family and Individual Therapy Services LLC
• Mid-Willamette Valley Community Action Agency, Inc
• Midwife Lennon LLC
• Holly Leah Miguel, FNP
• Rebekah Miles, BA
• Mill Creek Dental LLC
• Mill Creek Family Clinic Inc
• Mill Creek Medical Laboratory LLC
• Dakota Millak

• Nephrology Physician in Salem, OR
• Providers in Salem, OR by specialty
• Nephrology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.