Sean Mickle, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA055566 Issued in PA

Practice address

1 Guthrie SQ
Sayre, PA 18840-1625

Phone

(570) 888-5858

NPI assigned

Aug 16, 2012

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Evangelical Medical Services OrganizationGroup PAC ID 9133033087, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corning Hospital Hospital, Corning, NY, CCN 330277
• Robert Packer Hospital Hospital, Sayre, PA, CCN 390079

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smickle157399@direct-guthrie.org
• Direct secure messaging: smickle486000@wellspan.direct-ci.com

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.

• Wellspan Medical Group

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  Medicare reassignment Care Compare group NPD
• Evangelical Medical Services Organization

  • Surgery Physician
  • Lewisburg, PA
  • NPI 1205928967
  Medicare reassignment Care Compare group
• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Medicare reassignment NPD
• Corning Hospital

  • General Acute Care Hospital
  • Corning, NY
  • NPI 1346241973
  Medicare reassignment NPD
• Evangelical Medical Services Organization

  • Urology Physician
  • Lewisburg, PA
  • NPI 1083412084
  NPD
• Evangelical Medical Services Organization

  • Urgent Care Clinic/Center
  • Lewisburg, PA
  • NPI 1942227632
  NPD
• Robert Packer Hospital

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  NPD
• Wellspan Medical Group

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• Wellspan Medical Group

  • Diagnostic Radiology Physician
  • York, PA
  • NPI 1952587727
  NPD

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

• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Care Compare affiliation
• Robert Packer Hospital

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Care Compare affiliation
• Corning Hospital

  • General Acute Care Hospital
  • Corning, NY
  • NPI 1346241973
  Care Compare affiliation

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1073861381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858",
            "fax_number": "910-939-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLE",
        "first_name": "SEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-16",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MA0055566",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smickle157399@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Guthrie Sq",
            "city": "Sayre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "188401625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jay Kumar Mehta, MD
• Justin William Meinert, MD
• Aurora Merovci
• Marcelle Meseeha, MD
• Steven H Meyer, DPT
• Joseph Edward Mihalek III, RPH
• Kevin J. Millar, CRNA
• Stacy Ann Miller, CRNP
• Joyce Marie Milone
• Mindful and Kinetic Counseling LLC

• Medical Physician Assistant in Sayre, PA
• Providers in Sayre, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2021; 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.