Individual provider Active NPI

Tamika Mickie

  • Gerontology Nurse Practitioner
  • Horsham, PA
National Provider Identifier
1023697000
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP022939 Issued in PA
Practice address
680 Blair Mill Rd
Horsham, PA 19044-2223
Phone
(484) 781-5933
NPI assigned
Apr 6, 2021
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP022939 PA Primary
Registered Nurse 163W00000X RN635596 PA

Addresses

Primary practice location

680 Blair Mill Rd
Horsham, PA 19044-2223

Mailing address

3725 Rosemont Ave
Drexel Hill, PA 19026-3009

Other practice location 1

889 S Little Creek Rd
Dover, DE 19901-4721
Phone (302) 674-0566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250602000484 DE Practitioner - Nurse Practitioner 3173901931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Specialty Care LLCGroup PAC ID 1456742642, 6 clinicians
Geriatric Medicine Consultants PAGroup PAC ID 0244492072, 27 clinicians

Practice addresses (Care Compare)

Wilmington, DE 19808
Phone (302) 998-1151

1601 Milltown Rd
Suite 2
Wilmington, DE 19808-4047
Phone (302) 543-6165

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN635596PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Specialty Care LLC CurrentSince Apr 1, 2025 Accepting new patients
Geriatric Medicine Consultants PA CurrentSince May 1, 2025 Accepting new patients

Locations

1601 Milltown Rd
Ste 2
Wilmington, DE 19808
Phone (302) 463-6542

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 1

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1023697000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 ROSEMONT AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223",
            "telephone_number": "484-781-5933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "889 S Little Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199014721",
            "country_code": "US",
            "telephone_number": "302-674-0566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICKIE",
        "first_name": "TAMIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2026-09-29",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP022939",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN635596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

Verify at the official NPI Registry.