Timothy J Micek, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

23185 Issued in MS

Practice address

3964 Goodman Rd E
Suite 128
Southaven, MS 38672-8761

Phone

(662) 420-7350

Fax

(662) 874-5214

NPI assigned

Nov 1, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in IA, WV2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

82.15 of 100Reported as apm

Quality

47.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Appalachian Regional Healthcare, Inc

  • Family Medicine Physician
  • Beckley, WV
  • NPI 1477510162
  Medicare reassignment NPD
• Mercy Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Clinton, IA
  • NPI 1386832764
  Medicare reassignment NPD
• Appalachian Regional Healthcare, Inc

  • Community/Retail Pharmacy
  • Cumberland, KY
  • NPI 1710870811
  NPD
• Medical Associates of Clinton, Iowa P.L.C.

  • Family Medicine Physician
  • Clinton, IA
  • NPI 1841244431

  Orthopaedic Surgery

  NPD
• Mercy Specialty Clinic

  • Family Medicine Physician
  • Clinton, IA
  • NPI 1275197998
  NPD
• Cornerstone Orthopaedics

  • Orthopaedic Surgery Physician
  • Richmond, KY
  • NPI 1114087343
  NPD (past)
• Delta Orthopaedics & Sports Medicine, PLLC

  • Orthopaedic Surgery Physician
  • West Memphis, AR
  • NPI 1043565773
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1124106133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3964 GOODMAN RD",
            "address_2": "STE 128",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386726494",
            "telephone_number": "662-420-7350",
            "fax_number": "662-874-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3964 GOODMAN RD E",
            "address_2": "SUITE 128",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386728761",
            "telephone_number": "662-420-7350",
            "fax_number": "662-874-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICEK",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "64863",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD0000045338",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "23185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01988867",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Mengarelli
• Madalyn G Messick, PLPC
• Cathy G Meteer, LPC
• Kimberly Gwen Mettetal, C.F.N.P. CPMHNP
• Alexander Meyer, MD
• Michael E Foster MD PC
• Michael E Steuer MD PC
• Micheal G Cook OD PC
• Anna Kathryn Michell, COTA/L
• Mid South Otolaryngology Associates P.C.

• Orthopaedic Surgery Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Orthopaedic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.