Individual provider Active NPI

Michelle Mycka, DC

  • Chiropractor
  • Pottstown, PA
National Provider Identifier
1093867418
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006918R Issued in PA
Practice address
1106 Town Square Rd Ste 4
Pottstown, PA 19465-1017
Phone
(610) 469-0700
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC006918R PA Primary

Addresses

Primary practice location

1106 Town Square Rd Ste 4
Pottstown, PA 19465-1017

Mailing address

1106 Town Square Rd
Ste 4
Pottstown, PA 19465-1017
Phone (610) 469-0700

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Myckachiro@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120308000197 PA Practitioner - Chiropractic 7214964576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1106 Town Square Rd
Suite 4
Pottstown, PA 19465-1017
Phone (610) 469-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC006918RPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shelly Mycka, DC, PC CurrentSince Oct 1, 2014 Accepting new patients

Locations

1106 Town Square Rd
Ste 4
Pottstown, PA 19465
Phone (610) 469-0700

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1093867418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 TOWN SQUARE RD",
            "address_2": "STE 4",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194651017",
            "telephone_number": "610-469-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 TOWN SQUARE RD STE 4",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194651017",
            "telephone_number": "610-469-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYCKA",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006918R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Myckachiro@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "1106 Town Square Rd Ste 4",
            "city": "Pottstown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194651017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pottstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.