Adam Dean Mickey, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07049 Issued in NC

Practice address

2242 W Roosevelt Blvd Ste a
Monroe, NC 28110

Phone

(704) 220-1904

NPI assigned

Oct 17, 2014

Last updated

Jun 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.09 of 100Reported as group

Quality

65.78

Improvement activities

40

Cost

76.37

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Fastmed P.C.

  • Family Medicine Physician
  • Durham, NC
  • NPI 1629841788
  Medicare reassignment Care Compare group
• Fastmed Primary Care, P.C.

  • Family Medicine Physician
  • Fayetteville, NC
  • NPI 1912774423
  NPD (past)

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1073917209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 W ROOSEVELT BLVD STE A",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103071",
            "telephone_number": "704-220-1904",
            "fax_number": "704-776-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 W ROOSEVELT BLVD STE A",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "28110",
            "telephone_number": "704-220-1904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 W 8th St",
            "address_2": "Tower I, 8th floor",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096533",
            "country_code": "US",
            "telephone_number": "904-383-1022",
            "fax_number": "904-244-9439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2242 W Roosevelt Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "28110",
            "country_code": "US",
            "telephone_number": "704-220-1904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3250 Wilkinson Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282085665",
            "country_code": "US",
            "telephone_number": "704-319-5176",
            "fax_number": "704-395-6629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICKEY",
        "first_name": "ADAM",
        "middle_name": "DEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-17",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07049",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-07049",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9108348",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013627200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003156207A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Carlton Meyer, LMBT
• MG Transport
• Miayen Inc.
• Michael O Reimels DDS & Khalil Mjahed DDS PLLC (Monroe Family Dentistry)
• Eyob E. Michail, MD
• Mid-Carolina Neurology, P.a.
• Mighty Minds LLC
• Joanna Mikulski, MA, CCC-SLP
• Milestone Recovery LLC
• Anna Katherine Johnson Miller

• Physician Assistant in Monroe, NC
• Providers in Monroe, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.